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    Endocrine and Metabolic

    E-Poster Available

    (149) Effects of demographics on outcomes with empagliflozin vs. DPP4i

    Wednesday, October 29, 2025
    Has Audio

      Primary Author(s)

    • Sara Cromer, MD

      Associate Physician; Assistant Professor of Medicine
      Diabetes Center, Massachusetts General Hospital; Harvard Medical School
      Boston, Massachusetts, United States

      • Co-Author(s)

    • Helen Tesfaye, PharmD, MSc

      Research Specialist
      Division of Pharmacoepidemiology, Dept. of Medicine, Brigham & Women’s Hospital, Harvard Medical School
      Boston, Massachusetts, United States

    • Deborah J. Wexler, MD, MSc

      Associate Clinical Chief, MGH Diabetes Unit Clinical Director, MGH Diabetes Center
      MGH Diabetes Center, Division of Endocrinology, Dept of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
      Boston, Massachusetts, United States

    • Ariel Freedman, BS

      Research Assistant
      Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
      Boston, Massachusetts, United States

      • Presenter(s)

    • Christina Shay, PhD

      Director, Global Epidemiology and Real World Evidence
      Boehringer Ingelheim Pharmaceuticals, Inc.
      Ridgefield, Connecticut, United States

      • Co-Author(s)

    • Julie M. Paik, MD, ScD

      Assistant Professor of Medicine
      Division of Pharmacoepidemiology, Dept. of Medicine, Brigham & Women’s Hospital, Harvard Medical School
      Boston, Massachusetts, United States

    • Elisabetta Patorno, MD, DrPH

      Associate Professor of Medicine at Harvard Medical School, Associate Epidemiologist
      Division of Pharmacoepidemiology, Dept. of Medicine, Brigham & Women’s Hospital, Harvard Medical School
      Boston, Massachusetts, United States


    Background:     : Clinical trials were underpowered to examine if cardiovascular benefits of empagliflozin in patients with type 2 diabetes (T2D) are evenly distributed across demographic factors.

    Objective: : To evaluate the effect of baseline demographic factors on outcomes with empagliflozin vs dipeptidyl peptidase-4 (DPP4i) treatment in patients with T2D.

    Methods: : Using Medicare data (2014-2020), we compared 1:1 propensity score-matched patients aged ≥65 years with T2D initiating empagliflozin vs a DPP4i for the outcomes of major adverse cardiovascular events (MACE), hospitalization for heart failure (HHF), and mortality, overall and by age (65-74, ≥75 years), sex, race or ethnicity, adjusting for 147 baseline confounders. We estimated rate differences (RD) and hazard ratios (HR) with 95% confidence interval (CI) and assessed effect heterogeneity.

    Results: : After matching, empagliflozin was associated with decreased risk of MACE (HR [95% CI]=0.77 [0.72, 0.81]; RD= -10.10 [-12.38, -7.83]), HHF (HR=0.72 [0.69, 0.76]; RD= -17.68 [-20.45, -14.91]), and mortality (HR=0.66 [0.60, 0.72]; RD= -8.48 [-10.14, -6.82]) vs DPP4i, without evidence of effect heterogeneity by demographic factors except for age on the RD, or absolute, scale. Specifically, empagliflozin provided greater absolute benefits among patients aged ≥75 vs 65-74 years, with 17 vs. 7 fewer MACE events per 1000 person years, 25 vs. 14 fewer HHF events, and 12 vs 6 fewer deaths.

    Conclusions: : This study suggests that empagliflozin is beneficial for cardiovascular outcomes and mortality across subgroups of sex and race or ethnicity, though its absolute benefits may vary by age categories, with a higher degree of absolute benefit observed among older adults aged ≥75 vs 65-74 years.

    Sponsorship:: Boehringer Ingelheim