Diabetes medications with cardiovascular protection in the wake of EMPA-REG OUTCOME: the optimal combination may be metformin, pioglitazone and empagliflozin

EASD VIRTUAL MEETING. Webcast: RESULTS OF THE EMPA-REG OUTCOME™ STUDY. http://www.easdvirtualmeeting.org/contentsessions/2030 (accessed 7 October 2015)

Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015 (in press). http://dx.doi.org/10.1056/NEJMoa1504720

Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008;359:1577-89. http://dx.doi.org/10.1056/NEJMoa0806470

UK Prospective Diabetes Study Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854-65. http://dx.doi.org/10.1016/S0140-6736(98)07037-8

Ryder REJ. Pioglitazone has a dubious bladder cancer risk but an undoubted cardiovascular benefit. Diabet Med 2015;32:305-13. http://dx.doi.org/10.1111/dme.12627

Ryder REJ, DeFronzo RA. Rehabilitation of pioglitazone. Br J Diabetes Vasc Dis 2015;15:46-9. http://dx.doi.org/10.15277/bjdvd.2015.021

Dormandy JA, Charbonnel B, Eckland DJ, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet 2005;366:1279-89. http://dx.doi.org/10.1016/S0140-6736(05)67528-9

Lincoff AM, Wolski K, Nicholls SJ, Nissen SE. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. JAMA 2007;298:1180-8. http://dx.doi.org/10.1001/jama.298.10.1180

Wilcox R, Bousser MG, Betteridge DJ, et al, PROactive Investigators: Effects of pioglitazone in patients with type 2 diabetes with or without previous stroke: results from PROactive (PROspective pioglitAzone Clinical Trial In macroVascular Events 04). Stroke 2007;38:865-73. http://dx.doi.org/10.1161/01.STR.0000257974.06317.49

Erdmann E, Dormandy JA, Charbonnel B, et al. The effect of pioglitazone on recurrent myocardial infarction in 2,445 patients with type 2 diabetes and previous myocardial infarction: results from the PROactive (PROactive 05) Study. J Am Coll Cardiol 2007;49:1772-80. http://dx.doi.org/10.1016/j.jacc.2006.12.048

Mazzone T, Meyer PM, Feinstein SB, et al. Effect of pioglitazone compared with glimepiride on carotid intima-media thickness in type 2 diabetes: a randomized trial. JAMA 2006;296:2572-81. http://dx.doi.org/10.1001/jama.296.21.joc60158

Nissen SE, Nicholls SJ, Wolski K, et al. Comparison of pioglitazone vs glimepiride on progression of coronary atherosclerosis in patients with type 2 diabetes: the PERISCOPE randomized controlled trial. JAMA 2008; 299:1561-73. http://dx.doi.org/10.1001/jama.299.13.1561

Zannad F, McMurray JJ, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2011;364:11-21. http://dx.doi.org/10.1056/NEJMoa1009492

Bailey, CJ, Day C. SGLT2 inhibitors: glucuretic treatment for type 2 diabetes. Br J Diabetes Vasc Dis 2010;10:193-9. http://dx.doi.org/10.1177/1474651410377832

MacEwen, A, McKay, GA, Fisher M. Drugs for diabetes: part 8 SGLT2 inhibitors. Br J Cardiol 2012;19:26-9.

Kovacs CS, Seshiah V, Swallow R, et al. Empagliflozin improves glycaemic and weight control as add-on therapy to pioglitazone or pioglitazone plus metformin in patients with type 2 diabetes: a 24-week, randomized, placebo-controlled trial. Diabetes Obes Metab 2014;16:147-58. http://dx.doi.org/10.1111/dom.12188

Neal B, Perkovic V, de Zeeuw D, et al. Rationale, design, and baseline characteristics of the Canagliflozin Cardiovascular Assessment Study (CANVAS)–a randomized placebo-controlled trial. Am Heart J 2013; 166:217-223.e11. http://dx.doi.org/10.1016/j.ahj.2013.05.007

TIMI Study Group. DECLARE-TIMI 58. Available at http://www.timi.org/index.php?page=declare-timi-58 (accessed 7 October 2015)'

Ryder REJ. Rosiglitazone versus pioglitazone in relation to cardiovascular disease in type 2 diabetes – primum non nocere. Pract Diab Int 2007;24:422-5. http://dx.doi.org/10.1002/pdi.1168

Marso SP, Poulter NR, Nissen SE, et al. Design of the liraglutide effect and action in diabetes: evaluation of cardiovascular outcome results (LEADER) trial. Am Heart J 2013;166:823-30.e5. http://dx.doi.org/10.1016/j.ahj.2013.07.012

DeFronzo RA. Banting Lecture: from the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009;58:773-95. http://dx.doi.org/10.2337/db09-9028