From the Guidelines
Jardiance (Empagliflozin) is not a DPP-4 inhibitor, but rather an SGLT2 inhibitor, which has been shown to reduce the risk of heart failure hospitalization by 35% compared to placebo, as demonstrated in the EMPA-REG OUTCOME trial 1.
Key Points
- Jardiance (Empagliflozin) belongs to the class of SGLT2 inhibitors, not DPP-4 inhibitors, and works by helping the kidneys remove excess sugar from the bloodstream through urine.
- The mechanism of action of Jardiance is distinct from DPP-4 inhibitors, which increase incretin levels to regulate blood sugar.
- The EMPA-REG OUTCOME trial showed a significant 35% reduction in hospitalization for heart failure with the use of Empagliflozin compared to placebo 1.
- The EMPEROR-Preserved trial also demonstrated a 21% reduction in the composite outcome of cardiovascular death or hospitalization for heart failure with Empagliflozin compared to placebo 1.
Clinical Considerations
- Jardiance is typically prescribed at a starting dose of 10 mg once daily, with a possible increase to 25 mg daily if needed and tolerated.
- Patients should maintain adequate hydration while taking Jardiance due to its mechanism of action.
- Common side effects include urinary tract infections and genital yeast infections due to the increased glucose in urine.
- Patients with kidney problems may require dosage adjustments or may not be suitable candidates for this medication.
Evidence-Based Recommendation
- The use of Jardiance (Empagliflozin) is recommended for patients with type 2 diabetes who are at high risk of heart failure or have established heart failure, due to its proven benefits in reducing the risk of heart failure hospitalization 1.
From the Research
Mechanism of Action
- Empagliflozin (Jardiance) is a sodium glucose cotransporter-2 (SGLT2) inhibitor, not a DPP-4 medication 2, 3, 4.
- It works by inhibiting the reabsorption of glucose from the proximal tubules in the kidney, promoting glucosuria and reducing fasting and postprandial glycaemia 2, 4.
Therapeutic Effects
- Empagliflozin has been shown to improve glycemic control, reduce body weight, and lower blood pressure in patients with type 2 diabetes 2, 3, 5, 4.
- It has also demonstrated cardioprotective and renoprotective properties, reducing the risk of cardiovascular events and hospitalization for heart failure 3, 6, 5.
Safety and Tolerability
- Empagliflozin is generally well tolerated, with common adverse events including genital mycotic infections, mild urinary tract infections, and a risk of hypotension and volume depletion 2, 3, 5.
- It has a low inherent risk of hypoglycaemia due to its insulin-independent mechanism of action 2, 3, 4.