133-LB: Cardiovascular Outcomes in Older Adults Initiating Empagliflozin vs. DPP-4 Inhibitors and GLP-1 Receptor Agonists: A Subgroup Analysis from the EMPRISE Study

EMPRISE aims to study the effectiveness, safety and healthcare utilization of empagliflozin (EMPA) in routine care patients. In an interim analysis, we assessed the comparative cardiovascular (CV) effectiveness of EMPA in older adults. Using data from Medicare (2014-2017), we identified 11,579 pairs of 1:1 propensity score-matched patients ≥66 years with type 2 diabetes initiating EMPA or a DPP-4 inhibitor (DPP-4i), and 17,500 pairs initiating EMPA or a GLP-1 receptor agonist (GLP-1RA). We assessed hospitalization for heart failure (HHF), defined as a HF discharge diagnosis in the primary (HHF-Specific) or in any position (HHF-Broad) and a modified MACE outcome (MI, stroke, or all-cause mortality). We estimated HR and 95% CI adjusting for >140 baseline covariates. Compared to DPP-4i, EMPA was associated with a decreased risk of HHF [HHF-Specific: 0.43 (0.30-0.63); HHF-Broad: 0.57 (0.47-0.69)] and MACE [HR (95% CI) = 0.63 (0.50-0.79)]. Compared to GLP-1RA, EMPA had a reduced risk of HHF [HHF-Specific: 0.67 (0.50-0.91); HHF-Broad: 0.83 (0.71-0.96)] and a similar risk of MACE [1.02 (0.85-1.23)](Table 1). Results for the individual components of MACE were consistent and robust to competing risks. These findings, addressing the comparative effectiveness of EMPA in routine care patients with mean age of 72 years, complement available information from RCTs. Disclosure E. Patorno: Other Relationship; Self; Boehringer Ingelheim International GmbH. A. Pawar: None. L.G. Bessette: None. M. Najafzadeh: None. D.J. Wexler: Other Relationship; Self; Novo Nordisk A/S. J. Franklin: None. A. Deruaz-Luyet: Employee; Self; Boehringer Ingelheim International GmbH. Employee; Spouse/Partner; Sanofi-Aventis Deutschland GmbH. K. Brodovicz: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. L. Koeneman: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. S. Schneeweiss: None. Funding Boehringer Ingelheim