Empagliflozin Not Tied to Risk for New Nonproliferative Diabetic Retinopathy

TUESDAY, Dec. 17, 2024 (HealthDay News) — Empagliflozin initiation is not associated with incident nonproliferative diabetic retinopathy (NPDR) compared with initiation of a dipeptidyl peptidase 4 inhibitor (DPP4i), according to a study published online Dec. 5 in JAMA Ophthalmology.

Helen Tesfaye, Pharm.D., from Brigham and Women’s Hospital in Boston, and colleagues compared the risk for incident NPDR and DR progression in patients with type 2 diabetes (T2D) initiating empagliflozin versus a DPP4i. The analysis included 34,239 pairs of propensity score-matched adults in the incident NPDR cohort and 7,831 pairs in the DR progression cohort.

The researchers found that during a mean follow-up period of eight months receiving treatment, the risk for incident NPDR did not differ across groups (hazard ratio [HR], 1.04; 95 percent confidence interval [CI], 0.94 to 1.15; rate difference [RD], 1.30; 95 percent CI, −1.83 to 4.44). The risk for DR progression was lower among individuals who initiated empagliflozin versus those who began DPP4i therapy (HR, 0.78; 95 percent CI, 0.63 to 0.96; RD, −9.44; 95 percent CI, −16.90 to −1.98). Across multiple subgroups and sensitivity analyses, results were similar.

“Although residual confounding cannot be entirely ruled out due to the observational nature of our study, these findings may be helpful when weighing the risks and benefits of various glucose-lowering agents in adults with T2D,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including Boehringer Ingelheim and Eli Lilly, which manufacture empagliflozin; Boehringer Ingelheim funded the study.

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