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EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction (EMPEROR-Preserved)

A Phase III Randomised, Double-blind Trial to Evaluate Efficacy and Safety of Once Daily Empagliflozin 10 mg Compared to Placebo, in Patients With Chronic Heart Failure With Preserved Ejection Fraction (HFpEF)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03057951
Enrollment
5988
Registered
2017-02-20
Start date
2017-03-02
Completion date
2021-04-26
Last updated
2022-06-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart Failure

Brief summary

This is a study in adults with chronic heart failure. People with chronic heart failure may need to be hospitalised for their condition. Some people with chronic heart failure may eventually die from their condition. The purpose of the study is to find out whether a medicine called empagliflozin lowers the chances of patients having to go to hospital for heart failure and whether it improves their survival. The study is open to patients with a type of chronic heart failure called chronic heart failure with preserved ejection fraction. Participants stay in the study until researchers have enough information about how effective empagliflozin is. It is expected that participants who enter at the very beginning of the enrolment period may be in the study for over 3 years, while participants who enter near the end of the enrolment period may be in the study for less than 2 years. The participants are put into 2 groups. It is decided by chance who gets into which group. One group gets empagliflozin tablets every day and the other group gets placebo tablets every day. Placebo tablets look like empagliflozin tablets but contain no medicine. Participants visit the doctors regularly. During these visits, the doctors collect information about the participant's health. The doctors want to know how many patients had to go to hospital because of heart failure or who died from cardiovascular disease.

Interventions

DRUGEmpagliflozin

once daily

DRUGPlacebo

once daily

Sponsors

Eli Lilly and Company
CollaboratorINDUSTRY
Boehringer Ingelheim
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Male or female patient, age \>= 18 years at screening. For Japan only: Age \>=20 years at screening * Patients with chronic HF (Chronic Heart Failure) NYHA (New York Heart Association classification) class II-IV and preserved EF (Ejection Fraction)(LVEF (Left Ventricular Ejection Fraction) \> 40 %) and elevated NT-proBNP (N-terminal of the prohormone brain natriuretic peptide) \> 300 pg/ml for patients without AF, OR \> 900 pg/ml for patients with AF, analysed at the Central laboratory at Visit 1 * Structural heart disease within 6 months prior to Visit 1, OR documented HHF (Hospitalisation for Heart Failure) within 12 months prior to Visit 1 * Stable dose of oral diuretics, if prescribed * Signed and dated written ICF (informed consent form) * Further inclusion criteria apply

Exclusion criteria

* Myocardial infarction, coronary artery bypass graft surgery or other major cardiovascular surgery, stroke or TIA (Transient Ischaemic Attack) in past 90 days prior to Visit 1 * Heart transplant recipient or listed for heart transplant * Acute decompensated HF (Heart Failure) * Systolic blood pressure (SBP) \>= 180 mmHg at Visit 2. * Symptomatic hypotension and/or a SBP \< 100 mmHg * Indication of liver disease, * Impaired renal function, defined as eGFR (Estimated Glomerular Filtration Rate) \< 20 mL/min/1.73 m2 (CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Equation))cr or requiring dialysis * History of ketoacidosis * Current use or prior use of a SGLT (Sodium-glucose co-transporter) -2 inhibitor or combined SGLT-1 and 2 inhibitor * Currently enrolled in another investigational device or drug trial * Known allergy or hypersensitivity to empagliflozin or other SGLT-2 inhibitors * Women who are pregnant, nursing, or who plan to become pregnant while in the trial * Further

Design outcomes

Primary

MeasureTime frameDescription
Time to First Event of Adjudicated Cardiovascular (CV) Death or Adjudicated Hospitalisation for Heart Failure (HHF)From randomization until completion of the planned treatment phase, up to 1403 days.Failure with preserved Ejection Fraction (HFpEF). The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Secondary

MeasureTime frameDescription
eGFR (CKD-EPI) cr Slope of Change From BaselineAt baseline, week 4, 12, 32, 52, 76, 100, 124, 148, 172 and week 196, up to 1043 days.Glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR(CKD-EPI)cr) slope of change from baseline. Available on-treatment change-from-baseline data were used. The slope represents the long term effect of eGFR change from baseline and provides the yearly rate of decline. Timepoints after baseline were included in calculation of slope of change from baseline. The slope per patient was calculated using a random coefficient model with terms for treatment, region, baseline status of diabetes, age, sex, left ventricular ejection fraction (LVEF) and glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula (eGFR (CKD-EPI)cr) at baseline and in addition the factors time, treatment-by-time interaction, and baseline eGFR (CKD-EPI)cr-by-time interaction.
Time to the First Event in the Composite Renal Endpoint: Chronic Dialysis, Renal Transplant, or Sustained Reduction in eGFR (CKD-EPI)crFrom randomization until completion of the planned treatment phase, up to 1403 days.Chronic dialysis was defined as dialysis with a frequency of twice per week or more for at least 90 days. Sustained was determined by two or more consecutive post-baseline central laboratory measurement separated by at least 30 days. Reduction in glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr) was defined as reduction in eGFR from baseline ≥40%, eGFR \<15 mL/min/1.73 m\^2 for patients with baseline eGFR ≥30 mL/min/1.73 m\^2, or eGFR \<10 mL/min/1.73 m\^2 for patients with baseline eGFR \<30 mL/min/1.73 m\^2. The incidence rate per 100 patient years (100 \* number of patients with event / time at risk \[years\]) is reported. Time at risk \[year\] is calculated as: Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Abbreviation: Patient-years (pt-yrs).
Time to First Adjudicated Hospitalisation for Heart Failure (HHF)From randomization until completion of the planned treatment phase, up to 1403 days.Time to first adjudicated HHF. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.
Time to Adjudicated Cardiovascular (CV) DeathFrom randomization until completion of the planned treatment phase, up to 1403 days.Time to adjudicated CV death. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.
Occurrence of Adjudicated Hospitalisation for Heart Failure (HHF) (First and Recurrent)From randomization until completion of the planned treatment phase, up to 1403 days.Reported is the total number of adjudicated HHF events (first and recurrent) which occurred.
Time to Onset of Diabetes Mellitus (DM) in Patients With Pre-DMFrom randomization until completion of the planned treatment phase, to 1403 days.Time to onset of DM (defined as HbA1c ≥6.5% or as diagnosed by the investigator) in patients with pre-DM. Pre-DM was defined as no history of DM and no HbA1c ≥6.5% before treatment, and a pre-treatment HbA1c value of ≥5.7% and \<6.5%. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.
Change From Baseline in Kansas City Cardiomyopathy Questionaire (KCCQ) Clinical Summary Score at Week 52At baseline and at week 12, week 32 and week 52.The KCCQ is a 23-item self-administered questionnaire designed to evaluate physical limitations, symptoms (frequency, severity, and changes over time), social limitations, self-efficacy, and quality of life in patients with Heart Failure. The KCCQ-clinical summary score comprises the following domains: Symptom frequency, symptom burden and physical limitation. The score is calculated by summing domain responses and then transforming scores to a 0-100 unit scale with higher scores indicating better health status. For patients who died, a worst score (score of 0) was imputed for the score at all subsequent scheduled visits after the date of death where the score would have been assessed. Change from baseline in KCCQ-score at week 52 was modeled using a MMRM with visit (week 12, 32 and 52) as repeated measures, adjusted mean (standard error) at week 52 is reported.
Occurrence of All-cause Hospitalisation (First and Recurrent)From randomization until completion of the planned treatment phase, up to 1403 days.Occurrence of all-cause hospitalisation (first and recurrent). Total number of all cause hospitalisations is reported.
Time to All-cause MortalityFrom randomization until completion of the planned treatment phase, up to 1403 days.Time to all-cause mortality. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Countries

Argentina, Australia, Belgium, Brazil, Canada, China, Colombia, Czechia, Germany, Hungary, India, Italy, Japan, Mexico, Netherlands, Poland, Romania, Singapore, South Africa, South Korea, Spain, United Kingdom, United States

Participant flow

Recruitment details

A randomised, double-blind trial to demonstrate superiority of empagliflozin versus placebo in patients with symptomatic, chronic heart failure and preserved left ventricular ejection fraction (LVEF\>40%) under stable treatment of heart failure symptoms.

Pre-assignment details

Patients were included in the trial after they had signed the informed consent form (ICF). Patients who met all of the inclusion and none of the exclusion criteria were to be included in the trial. All patients were informed that they were free to withdraw their consent at any time during the trial without penalty or prejudice.

Participants by arm

ArmCount
Placebo
1 film-coated tablet of matching placebo was administered orally once daily in patients with chronic heart failure with preserved ejection fraction (HFpEF).
2,991
10 mg Empagliflozin
1 film-coated tablet of 10 milligram (mg) of empagliflozin was administered orally once daily in patients with chronic heart failure with preserved ejection fraction (HFpEF).
2,997
Total5,988

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event553575
Overall StudyDue to Covid-19 Pandemic28
Overall StudyInvestigator decision20
Overall StudyLost to Follow-up616
Overall StudyMedical advice62
Overall StudyNot attending study visits30
Overall StudyNot treated21
Overall StudyOther reason than stated above2329
Overall StudyPatient decision52
Overall StudyPatient moved away34
Overall StudyPatient refusal to continue, not due to AE304284
Overall StudyProtocol Violation3024
Overall StudyStudy drug stopped, reason missing61

Baseline characteristics

Characteristic10 mg EmpagliflozinTotalPlacebo
Age, Continuous71.8 Years
STANDARD_DEVIATION 9.3
71.9 Years
STANDARD_DEVIATION 9.4
71.9 Years
STANDARD_DEVIATION 9.6
Ethnicity (NIH/OMB)
Hispanic or Latino
770 Participants1524 Participants754 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
2227 Participants4463 Participants2236 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants1 Participants1 Participants
Race (NIH/OMB)
American Indian or Alaska Native
90 Participants194 Participants104 Participants
Race (NIH/OMB)
Asian
413 Participants824 Participants411 Participants
Race (NIH/OMB)
Black or African American
133 Participants258 Participants125 Participants
Race (NIH/OMB)
More than one race
60 Participants135 Participants75 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
14 Participants33 Participants19 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants2 Participants1 Participants
Race (NIH/OMB)
White
2286 Participants4542 Participants2256 Participants
Sex: Female, Male
Female
1338 Participants2676 Participants1338 Participants
Sex: Female, Male
Male
1659 Participants3312 Participants1653 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
427 / 2,991422 / 2,997
other
Total, other adverse events
1,274 / 2,9891,191 / 2,996
serious
Total, serious adverse events
1,543 / 2,9891,436 / 2,996

Outcome results

Primary

Time to First Event of Adjudicated Cardiovascular (CV) Death or Adjudicated Hospitalisation for Heart Failure (HHF)

Failure with preserved Ejection Fraction (HFpEF). The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboTime to First Event of Adjudicated Cardiovascular (CV) Death or Adjudicated Hospitalisation for Heart Failure (HHF)8.67 Patients with event/100 pt-yrs at risk
10 mg EmpagliflozinTime to First Event of Adjudicated Cardiovascular (CV) Death or Adjudicated Hospitalisation for Heart Failure (HHF)6.86 Patients with event/100 pt-yrs at risk
Comparison: Cox regression, with terms for treatment, region, baseline status of diabetes, age, sex, left ventricular ejection fraction (LVEF) and glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr) at baseline.~alpha=0.0497 (resulting from interim analysis).p-value: 0.000395.03% CI: [0.69, 0.9]Regression, Cox
Secondary

Change From Baseline in Kansas City Cardiomyopathy Questionaire (KCCQ) Clinical Summary Score at Week 52

The KCCQ is a 23-item self-administered questionnaire designed to evaluate physical limitations, symptoms (frequency, severity, and changes over time), social limitations, self-efficacy, and quality of life in patients with Heart Failure. The KCCQ-clinical summary score comprises the following domains: Symptom frequency, symptom burden and physical limitation. The score is calculated by summing domain responses and then transforming scores to a 0-100 unit scale with higher scores indicating better health status. For patients who died, a worst score (score of 0) was imputed for the score at all subsequent scheduled visits after the date of death where the score would have been assessed. Change from baseline in KCCQ-score at week 52 was modeled using a MMRM with visit (week 12, 32 and 52) as repeated measures, adjusted mean (standard error) at week 52 is reported.

Time frame: At baseline and at week 12, week 32 and week 52.

Population: Only Patients included in the treated set (TS) including values obtained on treatment. The number of patients analysed displays the number of patients with available data at the timepoint of interests.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Kansas City Cardiomyopathy Questionaire (KCCQ) Clinical Summary Score at Week 523.18 Score on a scaleStandard Error 0.31
10 mg EmpagliflozinChange From Baseline in Kansas City Cardiomyopathy Questionaire (KCCQ) Clinical Summary Score at Week 524.51 Score on a scaleStandard Error 0.31
Comparison: Model includes age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula (eGFR (CKD-EPI)), baseline Left ventricular ejection fraction (LVEF) as linear covariate(s) and region, baseline diabetes status, sex, week reachable, treatment-by-visit interaction, baseline KCCQ-Clinical-Summary-Score-by-visit interaction as fixed effect(s).~Unstructured covariance structure.p-value: 0.002895% CI: [0.45, 2.19]Mixed Model Repeated Measures (MMRM)
Secondary

eGFR (CKD-EPI) cr Slope of Change From Baseline

Glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR(CKD-EPI)cr) slope of change from baseline. Available on-treatment change-from-baseline data were used. The slope represents the long term effect of eGFR change from baseline and provides the yearly rate of decline. Timepoints after baseline were included in calculation of slope of change from baseline. The slope per patient was calculated using a random coefficient model with terms for treatment, region, baseline status of diabetes, age, sex, left ventricular ejection fraction (LVEF) and glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula (eGFR (CKD-EPI)cr) at baseline and in addition the factors time, treatment-by-time interaction, and baseline eGFR (CKD-EPI)cr-by-time interaction.

Time frame: At baseline, week 4, 12, 32, 52, 76, 100, 124, 148, 172 and week 196, up to 1043 days.

Population: Only patients included in the treated set (TS) and with available data for this endpoint.

ArmMeasureValue (MEAN)Dispersion
PlaceboeGFR (CKD-EPI) cr Slope of Change From Baseline-2.616 mL/min/ 1.73 meters squared/yearStandard Deviation 0.108
10 mg EmpagliflozineGFR (CKD-EPI) cr Slope of Change From Baseline-1.253 mL/min/ 1.73 meters squared/yearStandard Deviation 0.108
Comparison: Random coefficient model allowing for random intercept and random slope per patient, with factors age, baseline eGFR (CKD-EPI), baseline LVEF as linear covariate(s) and region, baseline diabetes status, sex, baseline-by-time interaction, treatment-by-time interaction and treatment as fixed effects.~Only 'on-treatment' data from treated patients were used. alpha=0.001. covariance structure: Unstructured.p-value: <0.000199.9% CI: [0.861, 1.865]Random intercept random coeff. model
Secondary

Occurrence of Adjudicated Hospitalisation for Heart Failure (HHF) (First and Recurrent)

Reported is the total number of adjudicated HHF events (first and recurrent) which occurred.

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboOccurrence of Adjudicated Hospitalisation for Heart Failure (HHF) (First and Recurrent)541 HHF events
10 mg EmpagliflozinOccurrence of Adjudicated Hospitalisation for Heart Failure (HHF) (First and Recurrent)407 HHF events
Comparison: Joint frailty model that accounts for dependence between recurrent HHF and cardiovascular death, with terms for age, baseline eGFR (CKD-EPK)cr, baseline LVEF, region, baseline diabetes status, sex, and treatment. eGFR (CKP-EPI)cr: Glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement LVEF: Left ventricular ejection fraction. alpha=0.0497 (resulting from interim analysis).p-value: 0.000995.03% CI: [0.61, 0.88]Joint frailty model
Secondary

Occurrence of All-cause Hospitalisation (First and Recurrent)

Occurrence of all-cause hospitalisation (first and recurrent). Total number of all cause hospitalisations is reported.

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboOccurrence of All-cause Hospitalisation (First and Recurrent)2769 Events of all-cause hospitialisations
10 mg EmpagliflozinOccurrence of All-cause Hospitalisation (First and Recurrent)2566 Events of all-cause hospitialisations
Comparison: Joint frailty model that accounts for the dependence between recurrent all-cause hospitalisation and all-cause mortality was used. Joint frailty model with terms for age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula (eGFR (CKD-EPI)), baseline Left ventricular ejection fraction (LVEF), treatment, region, baseline diabetes status and sex.p-value: 0.101295% CI: [0.85, 1.01]Joint frailty model
Secondary

Time to Adjudicated Cardiovascular (CV) Death

Time to adjudicated CV death. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboTime to Adjudicated Cardiovascular (CV) Death3.81 Patients with event /100 pt-yrs at risk
10 mg EmpagliflozinTime to Adjudicated Cardiovascular (CV) Death3.42 Patients with event /100 pt-yrs at risk
Comparison: Cox regression model included terms age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr), region, baseline diabetes status, sex, baseline Left ventricular ejection fraction (LVEF) and treatment.p-value: 0.295195% CI: [0.76, 1.09]Regression, Cox
Secondary

Time to All-cause Mortality

Time to all-cause mortality. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboTime to All-cause Mortality6.67 Patients with event /100 pt-yrs at risk
10 mg EmpagliflozinTime to All-cause Mortality6.60 Patients with event /100 pt-yrs at risk
Comparison: Cox regression model included terms age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr), region, baseline diabetes status, sex, baseline Left ventricular ejection fraction (LVEF) and treatment.p-value: 0.989395% CI: [0.87, 1.15]Regression, Cox
Secondary

Time to First Adjudicated Hospitalisation for Heart Failure (HHF)

Time to first adjudicated HHF. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboTime to First Adjudicated Hospitalisation for Heart Failure (HHF)5.97 Patients with event /100 pt-yrs at risk
10 mg EmpagliflozinTime to First Adjudicated Hospitalisation for Heart Failure (HHF)4.28 Patients with event /100 pt-yrs at risk
Comparison: Cox regression model included terms age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr), region, baseline diabetes status, sex, baseline Left ventricular ejection fraction (LVEF) and treatment.p-value: <0.000195% CI: [0.6, 0.83]Regression, Cox
Secondary

Time to Onset of Diabetes Mellitus (DM) in Patients With Pre-DM

Time to onset of DM (defined as HbA1c ≥6.5% or as diagnosed by the investigator) in patients with pre-DM. Pre-DM was defined as no history of DM and no HbA1c ≥6.5% before treatment, and a pre-treatment HbA1c value of ≥5.7% and \<6.5%. The incidence rate per 100 patient years (pt-yrs) is presented and calculated as followed: Incidence rate per 100 pt-yrs = 100 \* number of patients with event / time at risk \[years\]. Time at risk \[years\] = Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Patients without a specific endpoint event were censored at the last date the patient was known to be free of the event or at the end of the planned treatment period, whichever was earlier.

Time frame: From randomization until completion of the planned treatment phase, to 1403 days.

Population: Randomised Set (RS), including all randomised patients and with available data for this endpoint.

ArmMeasureValue (NUMBER)
PlaceboTime to Onset of Diabetes Mellitus (DM) in Patients With Pre-DM7.39 Patients with event /100 pt-yrs at risk
10 mg EmpagliflozinTime to Onset of Diabetes Mellitus (DM) in Patients With Pre-DM6.12 Patients with event /100 pt-yrs at risk
Comparison: Cox regression model included terms age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr), region, baseline diabetes status, sex, baseline Left ventricular ejection fraction (LVEF) and treatment.p-value: 0.153995% CI: [0.65, 1.07]Regression, Cox
Secondary

Time to the First Event in the Composite Renal Endpoint: Chronic Dialysis, Renal Transplant, or Sustained Reduction in eGFR (CKD-EPI)cr

Chronic dialysis was defined as dialysis with a frequency of twice per week or more for at least 90 days. Sustained was determined by two or more consecutive post-baseline central laboratory measurement separated by at least 30 days. Reduction in glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr) was defined as reduction in eGFR from baseline ≥40%, eGFR \<15 mL/min/1.73 m\^2 for patients with baseline eGFR ≥30 mL/min/1.73 m\^2, or eGFR \<10 mL/min/1.73 m\^2 for patients with baseline eGFR \<30 mL/min/1.73 m\^2. The incidence rate per 100 patient years (100 \* number of patients with event / time at risk \[years\]) is reported. Time at risk \[year\] is calculated as: Sum of time at risk \[days\] over all patients in a treatment group / 365.25. Abbreviation: Patient-years (pt-yrs).

Time frame: From randomization until completion of the planned treatment phase, up to 1403 days.

Population: Randomised Set (RS), including all randomised patients.

ArmMeasureValue (NUMBER)
PlaceboTime to the First Event in the Composite Renal Endpoint: Chronic Dialysis, Renal Transplant, or Sustained Reduction in eGFR (CKD-EPI)cr2.23 Patients with event /100 pt-yrs at risk
10 mg EmpagliflozinTime to the First Event in the Composite Renal Endpoint: Chronic Dialysis, Renal Transplant, or Sustained Reduction in eGFR (CKD-EPI)cr2.13 Patients with event /100 pt-yrs at risk
Comparison: Cox regression model included terms age, baseline glomerular filtration rate estimated by the chronic kidney disease epidemiology collaboration formula with serum creatinine measurement (eGFR (CKD-EPI)cr), region, baseline diabetes status, sex, baseline Left ventricular ejection fraction (LVEF) and treatment.p-value: 0.724395% CI: [0.73, 1.24]Regression, Cox

Source: ClinicalTrials.gov · Data processed: Mar 6, 2026