Comparative effectiveness and prescribing patterns of dapagliflozin vs empagliflozin in type 2 diabetes patients: a target trial emulation
Authors' conclusion
Dapagliflozin and empagliflozin showed similar cardiorenal and safety outcomes in T2D. However, unstable prior ACEI/ARB use may influence mortality risk with empagliflozin. Prescribing patterns highlight the importance of multidisciplinary care. Further prospective studies are needed.
Study context
- Population
- Patients with T2D, multi-institutional electronic health records, January 2016 to August 20231,662 per group after inverse probability of treatment weighting (IPTW)
- Participants
- 2,649 vs 2,046
- Comparison
- Dapagliflozin vs empagliflozin
- Dapagliflozinn = 2,649
- Empagliflozinn = 2,046reference
- Outcome
- Composite of:
- Sustained eGFR decline ≥30 %
- End-stage renal disease
- HF hospitalization
- All-cause mortality
Methodological detailsmulti-institutional electronic health records, inverse probability of treatment weighting, new-user design
- Multi-institutional electronic health records
- Inverse probability of treatment weighting
- New-user design
Main finding
As reported in the abstract
Primary composite outcome
- No significant differences in primary outcome between dapagliflozin and empagliflozin
- After IPTW
Further findings
Secondary outcomes
- No significant differences in secondary outcomes
All-cause mortality, subgroup without stable prior ACEI/ARB exposure
- Higher risk of all-cause mortality with empagliflozin
Prescribing patterns
- Dapagliflozin more often prescribed by cardiologists; endocrinologists and nephrologists favored empagliflozin
Safety
Safety outcomes: acute kidney injury, hypoglycemia, urinary tract infection, fracture
- No significant differences in safety outcomes
Original publication
Comparative effectiveness and prescribing patterns of dapagliflozin vs empagliflozin in type 2 diabetes patients: a target trial emulation. Diabetes Res Clin Pract. Published 22 August 2025. doi:10.
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