Empagliflozin linked to reduced progression of diabetic retinopathy

Medical Xpress / JAMA Ophthalmology ^ | Dec. 10, 2024 | Justin Jackson / Helen Tesfaye et al

[ConservativeMind]

An investigation finds empagliflozin (sold as Jardiance) may reduce the risk of diabetic retinopathy (DR) progression in patients with a history of nonproliferative diabetic retinopathy (NPDR) but showed no association with preventing new NPDR onset.

DR is one of the most common complications of type 2 diabetes, affecting 26% of patients in the United States in 2021. It is the leading cause of irreversible vision loss among working-age adults.

Empagliflozin, a sodium-glucose cotransporter-2 inhibitor (SGLT2i) primarily developed for glucose control, has shown benefits for cardiovascular and renal outcomes in past clinical trials. Its association with DR progression has remained unclear.

In the cohort study, the team analyzed the impact of empagliflozin on DR progression compared to dipeptidyl peptidase-4 inhibitors (DPP4i).

Insurance claims data from Medicare and two major commercial health plans were analyzed from a five-year pre-COVID period. Adults with type 2 diabetes who initiated empagliflozin or DPP4i therapy were divided into two groups: 34,239 matched pairs for evaluating the risk of developing new NPDR and 7,831 matched pairs for examining the progression of DR in those with preexisting NPDR. Cohorts were followed for an average of eight months after initiating either treatment.

For incident NPDR, no significant difference was observed between groups.

For DR progression, empagliflozin users experienced fewer events (158) than the DPP4i group (201), with an HR of 0.78. Cumulative incidence curves showed a divergence favoring empagliflozin for DR progression early in follow-up.

While empagliflozin did not affect the onset of NPDR, it was associated with a 22% reduction in DR progression risk among individuals with preexisting NPDR. Findings are consistent with prior post hoc analyses from the EMPA-REG OUTCOME trial, which showed a similar 22% risk reduction in DR-related events with empagliflozin compared to placebo.

[ConservativeMind]

Jardiance appears to prevent 22% of the risk of diabetic retinopathy patients from getting worse, versus another diabetic drug, dipeptidyl peptidase-4 inhibitors (DPP4i) therapy.

[ConservativeMind]

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[mass55th]

I’ve been on Jardiance for my Type II diabetes for about 5 years now. During that time, I’ve lost at least 36 pounds, which I’m very pleased about.

[EinNYC]

I was prescribed the closely related Farxiga for my T2 diabetes. It gave me terrible side effects and I could not continue taking it.

[mass55th]

"I was prescribed the closely related Farxiga for my T2 diabetes. It gave me terrible side effects and I could not continue taking it."

Years ago I was put on Metformin, but it caused stomach problems, and I had to stop it. That was the only oral diabetic medication I've ever had trouble with. I hope your doctor was able to find you a substitute that hasn't caused you problems.