{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:28:37Z","timestamp":1790234917161,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K08AG055670"],"award-info":[{"award-number":["K08AG055670"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate effectiveness and safety outcomes among patients with type 2 diabetes (T2D) initiating empagliflozin versus dipeptidyl peptidase\u20104 (DPP\u20104) inhibitor treatment across the broad spectrum of cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a population\u2010based cohort study we identified 39\u2009072 pairs of 1:1 propensity score\u2010matched adult patients with T2D initiating empagliflozin or DPP\u20104 inhibitors, using data from 2 US commercial insurance databases and Medicare between August 2014 and September 2017. The primary outcomes were a composite of myocardial infarction (MI)\/stroke, and hospitalization for heart failure (HHF). Safety outcomes were bone fractures, lower\u2010limb amputations (LLAs), diabetic ketoacidosis (DKA), and acute kidney injury (AKI). We estimated pooled hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for more than 140 baseline covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Study participants had a mean age of 60\u2009years and only 28% had established cardiovascular disease. Compared to DPP\u20104 inhibitors, empagliflozin was associated with similar risk of MI\/stroke (HR 0.99 [95% CI 0.81\u20101.21]), and lower risk of HHF (HR 0.48 [95% CI 0.35\u20100.67] and 0.63 [95% CI 0.54\u20100.74], based on a primary and any heart failure discharge diagnosis, respectively). The HR was 0.52 (95% CI 0.38\u20100.72) for all\u2010cause mortality (ACM) and 0.83 (95% CI 0.70\u20100.98) for a composite of MI\/stroke\/ACM. Empagliflozin was associated with a similar risk of LLA and fractures, an increased risk of DKA (HR 1.71 [95% CI 1.08\u20102.71]) and a decreased risk of AKI (HR 0.60 [95% CI 0.43\u20100.85]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In clinical practice, the initiation of empagliflozin versus a DPP\u20104 inhibitor was associated with a lower risk of HHF, ACM and MI\/stroke\/ACM, a similar risk of MI\/stroke, and a safety profile consistent with documented information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14593","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T22:58:01Z","timestamp":1635893881000},"page":"442-454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Effectiveness and safety of empagliflozin in routine care patients: Results from the\n                    <scp>EMPagliflozin compaRative effectIveness<\/scp>\n                    and\n                    <scp>SafEty<\/scp>\n                    (\n                    <scp>EMPRISE<\/scp>\n                    ) study"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8809-9898","authenticated-orcid":false,"given":"Elisabetta","family":"Patorno","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajinkya","family":"Pawar","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Wexler","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Diabetes Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Glynn","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1088-8579","authenticated-orcid":false,"given":"Lily G.","family":"Bessette","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Paik","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Renal Medicine, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Najafzadeh","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly G.","family":"Brodovicz","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH  Ingelheim Germany"},{"name":"Boehringer Ingelheim Pharmaceuticals, Inc.  Ridgefield Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7396-7392","authenticated-orcid":false,"given":"Anouk","family":"D\u00e9ruaz\u2010Luyet","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH  Ingelheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schneeweiss","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812389"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1811744"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S009"},{"key":"e_1_2_9_7_1","unstructured":"Administration USFaD. FDA Drug Safety Communication: FDA revises labels of SGLT2 inhibitors for diabetes to include warnings about too much acid in the blood and serious urinary tract infections.https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-revises-labels-sglt2-inhibitors-diabetes-include-warnings-about. Published 2015. Accessed."},{"key":"e_1_2_9_8_1","unstructured":"Administration USFaD. FDA Drug Safety Communication: FDA revises label of diabetes drug canagliflozin (Invokana Invokamet) to include updates on bone fracture risk and new information on decreased bone mineral density.https:\/\/www.fda.gov\/drugs\/drug\u2010safety\u2010and\u2010availability\/fda\u2010drug\u2010safety\u2010communication\u2010fda\u2010revises\u2010label\u2010diabetes\u2010drug\u2010canagliflozin\u2010invokana\u2010invokamet. Published 2015. Accessed"},{"key":"e_1_2_9_9_1","unstructured":"Administration USFaD. FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana Invokamet Invokamet XR).https:\/\/www.fda.gov\/media\/104870\/download. Published 2017. Accessed."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/L19-0320"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1701990"},{"issue":"2","key":"e_1_2_9_12_1","first-page":"52","article-title":"Baseline information from a post\u2010marketing monitoring program on empagliflozin: implications for study validity and exposure accrual","volume":"27","author":"Patorno EPA","year":"2018","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.02.013"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1924"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000032240.28636.BD"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2313"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-11-157"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(98)00161-9"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90047-Q"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.10.004"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006010073"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.10.004"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly197"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-127-8_Part_2-199710151-00064"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy078"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6058"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13184"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S010"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.329"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030183"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2022190"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k119"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4772"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1464"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12891"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.039177"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1096"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1551"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-0267"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-0849"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2812"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-0289"},{"key":"e_1_2_9_44_1","unstructured":"Administration USFaD. FDA Drug Safety Communication: FDA strengthens kidney warnings for diabetes medicines canagliflozin (Invokana Invokamet) and dapagliflozin (Farxiga Xigduo XR).https:\/\/www.fda.gov\/drugs\/drug\u2010safety\u2010and\u2010availability\/fda\u2010drug\u2010safety\u2010communication\u2010fda\u2010strengthens\u2010kidney\u2010warnings\u2010diabetes\u2010medicines\u2010canagliflozin. Published 2016. Accessed February 16 2021 2021."},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30256-6"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.11220720"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.14593","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.14593","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.14593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:05:01Z","timestamp":1761887101000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.14593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1111\/dom.14593"],"URL":"https:\/\/doi.org\/10.1111\/dom.14593","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/review5","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/review6","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v2\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v2\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.14593\/v2\/review1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"2021-06-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}