The EMPRISE analysis used 2014-2020 Medicare claims to compare propensity score-matched initiators of empagliflozin with those prescribed DPP-4 inhibitors or GLP-1 receptor agonists, all aged 65 and over with type 2 diabetes. Against DPP-4 inhibitors, empagliflozin carried hazard ratios of 0.77 for major cardiovascular events, 0.72 for heart failure hospitalisation and 0.66 for all-cause mortality; against GLP-1 receptor agonists the heart failure hazard ratio was 0.88. The absolute benefit varied by baseline cardiovascular disease but not by age, sex, race, ethnicity or socioeconomic measures.
Why it is interesting: Puts a trial-scale cardiovascular and mortality signal into routine claims data for people over 65, and reports where the absolute benefit concentrates.