What is the use of Jardiance (Empagliflozin)?

From the Guidelines

Jardiance (empagliflozin) is a highly recommended medication for managing type 2 diabetes, reducing cardiovascular risk, and providing benefits for heart failure patients, as evidenced by the most recent and highest quality study, EMPEROR-Reduced 1.

Key Benefits of Jardiance

• Reduces the risk of cardiovascular death and hospitalization by 21% (HR 0.79 [95% CI 0.69–0.90]; P < 0.001) in patients with heart failure and an ejection fraction of 40% or less 1
• Provides kidney protection and modest weight loss benefits
• Effective in managing type 2 diabetes by blocking sodium-glucose cotransporter-2 (SGLT2) in the kidneys, causing excess glucose to be eliminated through urine

Dosage and Administration

• The standard dose is 10 mg once daily, taken in the morning with or without food, which can be increased to 25 mg daily if needed for better glycemic control

Important Considerations

• Common side effects include genital yeast infections, urinary tract infections, and increased urination
• Patients should maintain adequate hydration while taking Jardiance and temporarily stop it during periods of reduced food and fluid intake, such as during illness
• Those with type 1 diabetes, severe kidney disease, or a history of diabetic ketoacidosis should not use this medication
• Regular monitoring of kidney function is recommended while on Jardiance therapy

Clinical Evidence

• The EMPA-REG OUTCOME trial showed that empagliflozin reduced the composite outcome of MI, stroke, and cardiovascular death by 14% (absolute rate 10.5% vs. 12.1% in the placebo group, HR in the empagliflozin group 0.86 [95% CI 0.74–0.99]; P = 0.04 for superiority) and cardiovascular death by 38% (absolute rate 3.7% vs. 5.9%, HR 0.62 [95% CI 0.49–0.77]; P < 0.001) 1
• The EMPEROR-Reduced trial demonstrated a 21% reduction (HR 0.79 [95% CI 0.69–0.90]; P < 0.001) of the primary composite outcome of cardiovascular death or hospitalization for worsening heart failure in patients with heart failure and an ejection fraction of 40% or less 1

From the FDA Drug Label

JARDIANCE is a sodium-glucose co-transporter 2 (SGLT2) inhibitor indicated: To reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure. To reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established cardiovascular disease. As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus.

The use of Jardiance (Empagliflozin) is to:

• Reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure
• Reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established cardiovascular disease
• Improve glycemic control as an adjunct to diet and exercise in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus 2 Key points about the use of Jardiance include:
• It is not recommended for patients with type 1 diabetes mellitus, as it may increase the risk of diabetic ketoacidosis
• It is not recommended for use to improve glycemic control in patients with type 2 diabetes mellitus with an eGFR less than 30 mL/min/1.73 m2 2

From the Research

Use of Jardiance (Empagliflozin)

• Jardiance (Empagliflozin) is a sodium glucose cotransporter-2 (SGLT2) inhibitor used for the treatment of adults with type 2 diabetes (T2D) 3, 4, 5.
• It is effective in lowering glucose levels, and also has a favorable effect on non-glycemic outcomes, including modest reductions in body weight and blood pressure 3, 5.
• Empagliflozin has been shown to have cardioprotective and renoprotective properties, reducing the risk of cardiovascular death, heart failure, and renal disease in patients with T2D and established cardiovascular disease (CVD) 3, 4, 6.
• The drug is generally well tolerated, with a low risk of hypoglycemia, and can be used as monotherapy or in combination with other antidiabetic agents 3, 5.
• Empagliflozin has been approved by the FDA for the reduction of cardiovascular death in adults with T2D and CVD, based on the findings of the EMPA-REG OUTCOME study 6.

Benefits of Empagliflozin

• Reduction in cardiovascular mortality and heart failure hospitalization 4, 6
• Reduction in all-cause mortality 6
• Reduction in incident or worsening nephropathy, progression to macroalbuminuria, and doubling of creatinine 6
• Reduction in the need for renal-replacement therapy 6
• Improvement in glycemic control, with a reduction in HbA1c levels 3, 5
• Reduction in body weight and blood pressure 3, 5

Patient Population

• Empagliflozin is indicated for the treatment of T2D in adults, particularly those with established CVD or at high risk of CVD 3, 4, 6.
• The benefits of empagliflozin have been observed across a range of baseline subgroups, including HbA1c level and renal function 6.