5 Steps to prevent Heart Disease

Wednesday, November 11, 2015

Diabetic Drug Trial with 32% RRR in all cause mortality

Empagliflozin (Jardiance) trial link 

"The benefit on survival was seen regardless of the cause of death — empagliflozin prevented one in three cardiovascular deaths, with a significant 38% relative risk reduction in cardiovascular mortality, as well as a significant 32% relative reduction in all-cause mortality."

"CV death was one component of the primary composite outcome, which also included nonfatal myocardial infarction (MI) or nonfatal stroke.
 It was the CV mortality benefit, however, that primarily drove the reduction in this end point."

"Empagliflozin is reducing death, the ultimate outcome," senior author of the study, Silvio Inzucchi, MD, of Yale Diabetes Center, New Haven, Connecticut, told Medscape Medical News. "This is a first in my lifetime — a diabetes drug trial that has shown improved outcomes in high-risk cardiovascular patients."

"He admitted, however, that the investigators "don't understand our findings," because empagliflozin did not seem to have any significant effect on MI or stroke, so "this may not be an atherosclerotic effect. If it were, we would expect to have seen an effect on MI and stroke.

"Most good trials raise more questions than they answer, but it may be that we have had the treatment of diabetes wrong for 50 years," Dr Inzucchi controversially observed. "We can control the glucose, but [we have been doing that] without controlling the calorie excess," he continued. By causing glucose to be excreted in the urine, empagliflozin may be aiding this, "and we may have to rethink our strategy."

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