From the Guidelines
Jardiance (empagliflozin) is a highly recommended medication for managing type 2 diabetes and reducing cardiovascular risk, particularly in patients with established heart failure, due to its proven benefits in reducing the risk of worsening heart failure and cardiovascular death, as demonstrated in the EMPEROR-Reduced trial 1.
Key Benefits of Jardiance
- Reduces the risk of cardiovascular death by 38% and the composite outcome of MI, stroke, and cardiovascular death by 14%, as shown in the EMPA-REG OUTCOME trial 1
- Offers significant benefits for heart failure patients, including a 21% reduction in the primary composite outcome of cardiovascular death or hospitalization for worsening heart failure, as demonstrated in the EMPEROR-Reduced trial 1
- Provides kidney protection, with a 30% lower risk of the primary composite outcome of end-stage kidney disease, doubling of serum creatinine, or death from renal or cardiovascular causes, as shown in the CANVAS trial 1
Dosage and Administration
- Typically prescribed at 10mg or 25mg once daily, taken in the morning with or without food
- Patients should maintain adequate hydration while taking this medication and temporarily stop it during severe illness, surgery, or if unable to eat or drink normally
Important Considerations
- Jardiance should not be used by patients with type 1 diabetes or diabetic ketoacidosis
- Regular monitoring of kidney function is important while using this medication, and patients should inform healthcare providers about all other medications they're taking to avoid potential interactions
- Common side effects include genital yeast infections, urinary tract infections, and increased urination
Clinical Recommendations
- In people with type 2 diabetes and established HFpEF or HFrEF, an SGLT2 inhibitor with proven benefit in this patient population, such as Jardiance, is recommended to reduce the risk of worsening heart failure and cardiovascular death 1
- Jardiance is also recommended for its kidney protective effects, particularly in patients with diabetic kidney disease, as demonstrated in the DAPA-CKD trial 1
From the FDA Drug Label
1 INDICATIONS AND USAGE JARDIANCE is indicated: as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, to reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
Limitations of Use JARDIANCE is not recommended for patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.
- Indications for Jardiance:
- Improve glycemic control in adults with type 2 diabetes mellitus
- Reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease
- Limitations of Use: Not recommended for patients with type 1 diabetes or for the treatment of diabetic ketoacidosis 2
From the Research
Overview of Jardiance
- Jardiance, also known as empagliflozin, is a sodium glucose cotransporter-2 (SGLT2) inhibitor used in the treatment of type 2 diabetes 3, 4, 5, 6, 7.
- It is an effective and generally well-tolerated antihyperglycaemic agent, approved for use in adults with type 2 diabetes in several countries 3.
Mechanism of Action and Benefits
- Empagliflozin works by inhibiting the reabsorption of glucose from the proximal tubules in the kidney, providing a novel insulin-independent mechanism of lowering blood glucose 3, 6.
- It offers several benefits, including:
- Improved glycaemic control 3, 4, 5, 6, 7
- Reductions in body weight and blood pressure 3, 4, 6, 7
- Cardioprotective and renoprotective properties, particularly in patients with established cardiovascular disease 3, 4, 5
- Low inherent risk of hypoglycaemia due to its insulin-independent mechanism of action 3, 6
Safety and Tolerability
- Empagliflozin is generally well-tolerated, with most adverse events being mild or moderate in intensity 3, 4, 6.
- Common adverse effects include genital infections, kidney failure, and diabetic ketoacidosis 4.
- There is also a potential risk of cancer, particularly bladder cancer, although this is still being investigated 4.
Clinical Evidence
- Several clinical trials have demonstrated the efficacy and safety of empagliflozin in patients with type 2 diabetes, including the EMPA-REG OUTCOME trial 3, 4, 5.
- A systematic review and economic evaluation of empagliflozin and other SGLT2 inhibitors found that they are effective in improving glycaemic control, promoting weight loss, and lowering blood pressure, although they may not be cost-effective compared to other treatments 7.