EMPEROR-Preserved: Empagliflozin stable across age groups

Data from the EMPEROR-Preserved trial showed that empagliflozin had a favourable effect on major cardiovascular outcomes and sustained renal function irrespective of the age of patients with heart failure with preserved ejection fraction (HFpEF). Furthermore, the safety profile of empagliflozin in the eldery population did not reveal clinically relevant issues.

The sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin has been shown safe and efficacious in patients with HFpEF in the EMPEROR-Preserved trial (NCT03057951) [1]. The current analysis, presented by Prof. Michael Böhm (University of the Saarland, Germany), investigated the efficacy of empagliflozin in the study population of this trial according to age. The EMPEROR-Preserved trial randomised 5,988 patients with heart failure and an ejection fraction of ≥40% to either placebo or empagliflozin [2]. The primary outcome was a composite of cardiovascular death or hospitalisation for heart failure. For the current analysis, patients were stratified into 4 age groups: <65 years, 65–74 years, 75–79 years, and ≥80 years.

After 52 weeks of treatment, no interaction effect was seen between age and the efficacy of empagliflozin on the primary outcome measure (P_trend=0.33). The corresponding hazard ratios for participants in the empagliflozin arm were 0.83, 0.86, 0.72, and 0.73 (youngest to oldest age group). Additionally, kidney function as measured by eGFR slope was stable across the age groups in empagliflozin users (P_trend =0.32), indicating that the protection of the kidney is not associated with age. Finally, participants on empagliflozin were less likely to deteriorate concerning quality-of-life, measured through the Kansas City Cardiomyopathy Questionnaire (KCCQ) – Clinical Summary Score, and this effect was independent of age.

1. Anker SD, et al. N Engl J Med. 2021;385(16):1451–1461.
2. Böhm M, et al. Empagliflozin improves cardiovascular and renal outcomes in patients with preserved ejection fraction irrespective of age: Insights from the EMPEROR-Preserved Trial. ePosters – focus on Chronic Heart Failure 1, Heart Failure 2022, 21–24 May, Madrid, Spain.

 

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Posted on 28 July, 2022