Fewer Die – But Why?
Well, here’s an interesting situation: a drug that seems to have a definite benefit, but not for the reasons anyone expected, and not for reasons that anyone even understands. The drug is Jardiance (empagliflozin), for diabetes, and the benefit is a flat-out survival benefit, a significant effect on cardiovascular mortality. As Matthew Herper correctly points out here, people have been looking for such an outcome from diabetes drugs for a long time, without finding all that much. Type II diabetes certainly seems to be a significant factor raising cardiovascular risks (through effects on blood vessel walls, and probably other mechanisms as well), so you’d think that the various means of keeping blood glucose levels under control would show up on that very important bottom line. But to a great extent, they don’t seem to. Until now. Here’s the paper in the NEJM, and it’s hard to argue with. Of the hard endpoints, which one is more stony than death? De mortuis non disputandum est. Out of about 7000 patients, death from any cause was at 5.7% in the pooled drug treatment group, and 8.3% in the controls. No significant adverse event differences were seen between the two groups, Continue reading >>