{"id":"e90aec3951ee","type":"article","url":"https://hartvaat.nl/2026/10/26/geen-verschil-in-genitourinaire-veiligheid-tussen-dapagliflozin-en-empagliflozin/","title":"Geen verschil in genitourinaire veiligheid tussen dapagliflozin en empagliflozin bij HFpEF","title_en":"Same Class, Different Risk? Dapagliflozin versus Empagliflozin and Genitourinary Safety in Heart Failure with Preserved Ejection Fraction: A Retrospective Comparative Cohort Study.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Romanian journal of internal medicine = Revue roumaine de medecine interne","doi":"10.2478/rjim-2026-0024","source_url":"https://doi.org/10.2478/rjim-2026-0024","authors":["Razvan Alexandru Danau","Madalina Andreea Munteanu","Minerva Muraru","Camelia Nicolae","Gabriel Predoiu","Andreea Bardan","Viorel Jinga"],"significance":4,"published":"2026-11-01","source_date":"2026-10-26","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/wat-is-hartfalen/","https://hartvaat.nl/kennis/hartfalen/hfpef-hartfalen-met-behouden-ejectie/"],"congress":"","summary_en":"A retrospective single-centre cohort study of 239 patients with HFpEF compared the genitourinary safety of dapagliflozin versus empagliflozin over six months. Symptomatic UTIs occurred in 3.5% versus 4.0% of patients, and asymptomatic bacteriuria in 15.0% versus 15.9%, with no statistically significant difference between groups (adjusted OR 1.62; 95% CI 0.76–3.45). While the findings suggest comparable safety profiles, wide confidence intervals and the retrospective design mean these results should be interpreted cautiously and confirmed in prospective multicentre trials before influencing routine prescribing.","created":"2026-10-26T02:03:26Z","updated":"2026-10-26T02:03:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve cohortstudie onder 239 patiënten met hartfalen met behoud van ejectiefractie (HFpEF) vergeleek de genitourinaire veiligheid van dapagliflozin en empagliflozin over zes maanden. Symptomatische urineweginfecties en bacteriurie traden op bij respectievelijk 3,5% versus 4,0% en 15,0% versus 15,9% van de patiënten, zonder statistisch significant verschil (OR 1,62; 95%-BI 0,76–3,45). Hoewel de uitkomsten geen veiligheidsverschil aantonen, zijn de betrouwbaarheidsintervallen breed en vereisen ze bevestiging in prospectieve multicenteronderzoeken voordat ze klinische besluitvorming sturen.","abstract_original":"BACKGROUND: Sodium-glucose cotransporter 2 inhibitors are guideline-directed therapy for heart failure with preserved ejection fraction (HFpEF), but comparative genitourinary safety data for dapagliflozin and empagliflozin in HFpEF-treated populations remain limited. OBJECTIVE: To compare 6-month symptomatic urinary tract infection (UTI), asymptomatic bacteriuria, and other genitourinary adverse events among patients newly initiated on dapagliflozin or empagliflozin for HFpEF. METHODS: This retrospective, single-centre comparative cohort study included 239 adults with physician-documented HFpEF retained after a requirement for at least 6 months of continuous follow-up: 113 received dapagliflozin 10 mg once daily and 126 received empagliflozin 10 mg once daily. The original outcome of any documented bacteriuria/UTI was separated into symptomatic UTI and asymptomatic bacteriuria. Risk differences and 95% confidence intervals were calculated; a multivariable logistic model of the original documented bacteriuria/UTI composite adjusted for age, sex, and baseline estimated glomerular filtration rate (eGFR). RESULTS: Any documented bacteriuria/UTI occurred in 21/113 (18.6%) dapagliflozin-treated participants and 25/126 (19.8%) empagliflozin-treated participants. Symptomatic UTI occurred in 4/113 (3.5%) and 5/126 (4.0%), respectively; 17/113 (15.0%) and 20/126 (15.9%) had documented asymptomatic bacteriuria. The risk difference for the composite, calculated as empagliflozin minus dapagliflozin, was 1.3 percentage points (95% CI -8.9 to 11.2). The adjusted odds ratio was 1.62 (95% CI 0.76-3.45; p = 0.208). Other genitourinary events were uncommon and estimates were imprecise. CONCLUSIONS: No statistically detectable between-group difference was found in symptomatic UTI, asymptomatic bacteriuria, or the original composite outcome. Confidence intervals were wide and compatible with clinically meaningful differences in either direction. These exploratory findings require confirmation in prospective multicentre studies with standardized culture ascertainment and complete follow-up."}