Longato E, Bonora BM, Di Camillo B, et al. - Better cardio-renal outcomes and lower all-cause mortality were achieved with sodium glucose cotransporter-2 inhibitors (SGLT2i) initiation, vs dipeptidyl peptidase-4 inhibitors (DPP4i) initiation, under routine care in type 2 diabetes (T2D) patients.

• An administrative claims database of >5,2M citizen was used.

• Propensity score matching was applied.

• Post-matching, 3216 patients/group were included, and 20% had cardiovascular disease.

• A median follow-up of 18 months showed a lower rate of 3-point major adverse cardiovascular events with SGLT2i initiation vs DPP4i.

• Significantly lower rates of myocardial infarction (HR 0.75), hospitalization for heart failure (HR 0.44) or cardiovascular causes (HR 0.72), and all-cause death (HR 0.49) were found in SGLT2i initiators.

• Kidney failure was less common in relation to SGLT2i use than with DPP4i use.

• Outcomes were consistent with those acquired in a meta-analysis of 10 observational studies on ∼1,5M patients.