Dapagliflozin Appears to Be a Safe Option in Patients with Diabetes

Dapagliflozin, a sodium–glucose cotransporter 2 (SGLT2) inhibitor, blocks glucose resorption in the kidney's proximal tubule and reduces not only glucose levels but also risk for heart failure. The DECLARE–TIMI 58 trial (NCT01730534) tested the effect of dapagliflozin in people with diabetes who had, or were at high risk for, cardiovascular disease. The primary outcome was the combination of cardiovascular death, myocardial infarction, or ischemic stroke.

A total of 17,160 people were randomized to receive dapagliflozin (10 mg/day) or placebo. Median follow-up was 4.2 years; mean HbA_1c was 8.3%. In a safety analysis, dapagliflozin met the prespecified criterion for noninferiority. An efficacy analysis found no significant difference in risk …