Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular and renal benefits in type 2 diabetes mellitus (T2DM), but comparative effectiveness between individual agents in lower-risk populations remains unclear. A nationwide cohort study published in Diabetes Research and Clinical Practice evaluated outcomes with empagliflozin and dapagliflozin in patients without established cardiovascular or renal disease.

Using the Korean National Health Insurance Service database, the study identified 135,559 adults with T2DM who newly initiated either empagliflozin or dapagliflozin. After 1:1 propensity score matching, outcomes were compared between groups. The primary outcome was a composite of cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, or progression to end-stage renal disease (ESRD). Secondary outcomes included major adverse cardiovascular events (MACE) and individual components of the primary endpoint.

The analysis showed no significant difference in the risk of the primary outcome between empagliflozin and dapagliflozin (hazard ratio 0.98; 95% confidence interval, 0.89-1.09). Secondary outcomes were also similar between the two groups, and results remained consistent across sensitivity analyses.

These findings indicate comparable effectiveness of empagliflozin and dapagliflozin for preventing cardiorenal outcomes in patients with T2DM without established cardiovascular or renal disease.