Table 2

SGLT2 inhibitors: clinical efficacy and safety

CanagliflozinDapagliflozinEmpagliflozinErtugliflozin
Baseline HbA1c7.94–7.96%7.9–8.2%7.9%8.1–8.2%
Baseline HbA1c (mmol/mol)6363–666365–66
Δ HbA1c (low dose)−0.62% (100 mg)−0.4% (5 mg)−0.6% (10 mg)−0.5% (5 mg)
Δ HbA1c (low dose) (mmol/mol)−7 (100 mg)−4 (5 mg)−7 (10 mg)−6 (5 mg)
Δ HbA1c (high dose)−0.77% (300 mg)−0.5% (10 mg)−0.6% (25 mg)−0.7% (15 mg)
Δ HbA1c (high dose) (mmol/mol)−9 (300 mg)−6 (10 mg)−7 (25 mg)−8 (15 mg)
Δ Weight (low dose)−2.5% (100 mg)−2.2 kg (5 mg)−2.0% (10 mg)−1.8 kg (5 mg)
Δ Weight (high dose)−2.9% (300 mg)−2.0 kg (10 mg)−2.5% (25 mg)−1.7 kg (15 mg)
Δ Systolic BP (low dose)−3.7 mmHg (100 mg)−4.5 mmHg (5 mg)−4.1 mmHg (10 mg)−3.3 mmHg (5 mg)
Δ Systolic BP (high dose)−5.4 mmHg (300 mg)−5.3 mmHg (10 mg)−4.8 mmHg (25 mg)−3.8 mmHg (15 mg)
CV outcome trial*CANVASDECLARE-TIMI 58EMPA-REG OUTCOME
 MACE risk reduction0.86 (0.75–0.97)0.93 (0.84–1.03)0.86 (0.74–0.99)
 Heart failure (hospitalization)0.67 (0.52–0.87)0.73 (0.61–0.88)0.65 (0.50–0.85)
 Death (CV)0.87 (0.72–1.06)0.98 (0.82–1.17)0.62 (0.49–0.77)
 Death (any cause)0.87 (0.74–1.01)0.93(0.82–1.03)0.68 (0.57–0.82)
 Nonfatal MI (except silent MI)0.85 (0.69–1.05)0.89(0.77–1.01)0.87 (0.70–1.09)
 Nonfatal stroke0.90 (0.71–1.15)1.01 (0.84–1.21)1.24 (0.92–1.67)
 Progression of kidney disease0.73 (0.67–0.79)0.53 (0.43–0.66)0.61 (0.53–0.70)
  • Four SGLT2 inhibitors have been approved by the U.S. FDA for the treatment of type 2 diabetes. Data have been taken from the FDA-approved prescribing information for each drug and/or from the cardiovascular (CV) outcome trials (13,53). The prescribing information expresses HbA1c as a percent (NGSP units). HbA1c levels in International Federation of Clinical Chemistry (IFFC) units (mmol/mol) were generated using the conversion tool at http://www.ngsp.org/convert1.asp, which uses the following equation for the conversion: NGSP = (0.09148 × IFCC) + 2.152. Accordingly, it is not straightforward to accomplish the conversion for mean Δ HbA1c. For purposes of the article, we have estimated Δ HbA1c (mmol/mol) by assuming that the baseline HbA1c was ∼8.0% (64 mmol/mol) and calculating the change in HbA1c if that baseline HbA1c were decreased by reported change in HbA1c. For example, if the prescribing information reports that Δ HbA1c = −0.6%, this would correspond to an HbA1c of 7.4% (relative to a baseline HbA1c of 8.0%). The website converts an HbA1c of 7.4% to 57 mmol/mol. Thus, we have subtracted 64 mmol/mol from 57 mmol/mol, thereby converting a value of Δ HbA1c = −0.6% to Δ HbA1c = −7 mmol/mol. This should be viewed as an approximation. It would be necessary to convert data on individual patients before averaging to accomplish an exact unit conversion. BP, blood pressure; MI, myocardial infarction.

  • *For the CV outcome trials, data are hazard ratio (95% CI). Because the CV outcome study for ertugliflozin is still in progress, data are not yet available.