Empagliflozin associated with reduced MACE, heart failure, and mortality versus DPP4 inhibitors in observational Medicare study

Using propensity score-matched Medicare claims data (2014-2020), this real-world analysis compared adults aged ≥65 with type 2 diabetes who initiated empagliflozin versus dipeptidyl peptidase-4 inhibitors or GLP-1 receptor agonists. Empagliflozin was associated with lower rates of major adverse cardiovascular events (HR 0.77), hospitalization for heart failure (HR 0.72), and all-cause mortality (HR 0.66) versus DPP4 inhibitors, with consistent effects across sociodemographic subgroups but greater absolute benefits in those with prevalent cardiovascular disease.