Skip to main content
Have a personal or library account? Click to login
Same Class, Different Risk? Dapagliflozin versus Empagliflozin and Genitourinary Safety in Heart Failure with Preserved Ejection Fraction: A Retrospective Comparative Cohort Study Cover

Same Class, Different Risk? Dapagliflozin versus Empagliflozin and Genitourinary Safety in Heart Failure with Preserved Ejection Fraction: A Retrospective Comparative Cohort Study

Romanian Journal of Internal Medicine
AHEAD OF PRINT
By: ,  ,  ,  ,  ,   and    
Open Access
|Oct 2026
Read online
Figures & tables

Figures & Tables

Figure 1.

Participant flow and construction of the analytic cohort. HFpEF, heart failure with preserved ejection fraction; SGLT2, sodium–glucose cotransporter 2.

Table 1.

Baseline characteristics by treatment group.

CharacteristicDapagliflozin (n = 113)Empagliflozin (n = 126)Effect estimatep value
Age, years, mean ± SD (median [IQR])71.43 ± 10.67 (71 [64–80])66.40 ± 6.36 (67 [62.25–70])N/A0.0001
BMI, kg/m2, mean ± SD (median [IQR])26.91 ± 4.08 (27 [24–30])26.55 ± 2.97 (26.70 [24.82–28.30])N/A0.480
HbA1c, %, mean ± SD (median [IQR])5.52 ± 1.00 (5.10 [4.90–6.40])5.55 ± 0.98 (5.10 [5.00–6.35])N/A0.751
Systolic BP, mmHg, mean ± SD (median [IQR])133.89 ± 12.02 (135 [125–140])136.27 ± 11.63 (135 [126.25–145])N/A0.097
eGFR, mL/min/1.73 m2, mean ± SD (median [IQR])60.24 ± 13.28 (55 [49–71])59.88 ± 12.53 (55 [50–69])N/A0.966
Male sex, n (%)67/113 (59.3%)72/126 (57.1%)OR 1.09 [0.65–1.83]0.793
Dyslipidaemia, n (%)104/113 (92.0%)112/126 (88.9%)OR 1.44 [0.60–3.48]0.512
Smoking, n (%)48/113 (42.5%)43/126 (34.1%)OR 1.43 [0.84–2.41]0.230

[i] BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; HbA1c, glycated haemoglobin; IQR, interquartile range; N/A, not applicable; OR, odds ratio; SD, standard deviation.

Table 2.

Six-month adverse events in the final analytic cohort.

OutcomeDapagliflozinEmpagliflozinRisk difference, percentage points [95% CI]p value
Any documented bacteriuria/UTI21/113 (18.6%)25/126 (19.8%)1.3 [−8.9 to 11.2]0.870
Symptomatic UTI4/113 (3.5%)5/126 (4.0%)0.4 [−5.3 to 5.9]1.000
Documented asymptomatic bacteriuria17/113 (15.0%)20/126 (15.9%)0.8 [−8.6 to 10.0]1.000
Fracture1/113 (0.9%)0/126 (0.0%)−0.9 [−4.8 to 2.2]0.473
Amputation0/113 (0.0%)0/126 (0.0%)No events observedN/A
Diabetic ketoacidosis0/113 (0.0%)0/126 (0.0%)No events observedN/A
Genital fungal infection6/113 (5.3%)5/126 (4.0%)−1.3 [−7.6 to 4.4]0.760
Phimosis (males only)2/67 (3.0%)1/72 (1.4%)−1.6 [−8.9 to 4.8]0.609

[i] CI, confidence interval; N/A, not applicable; UTI, urinary tract infection. Risk differences are empagliflozin minus dapagliflozin.

Table 3.

Multivariable logistic regression for the original documented bacteriuria/UTI composite (n = 239).

VariableAdjusted OR95% CIp value
Empagliflozin versus dapagliflozin1.620.76–3.450.208
Age (per 1-SD increase)1.801.22–2.660.003
Male sex0.440.22–0.860.017
eGFR (per 1-SD increase)0.900.65–1.260.546

[i] CI, confidence interval; eGFR, estimated glomerular filtration rate; OR, odds ratio; SD, standard deviation.

DOI: https://doi.org/10.2478/rjim-2026-0024 | Journal eISSN: 2501-062X (formerly 1220-4749) | Journal ISSN: 1220-4749
Journal RSS Feed
Language: English, Romanian
Submitted on: Aug 18, 2026
Published on: Oct 26, 2026
Published by: N.G. Lupu Internal Medicine Foundation
In partnership with: Paradigm Publishing Services
Keywords:
SGLT2 inhibitor,
dapagliflozin,
empagliflozin,
heart failure with preserved ejection fraction,
urinary tract infection,
bacteriuria,
genital infection,
phimosis
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Internal medicine, other,
Cardiology,
Gastroenterology,
Rheumatology

© 2026 Razvan Alexandru Danau, Madalina Andreea Munteanu, Minerva Muraru, Camelia Nicolae, Gabriel Predoiu, Andreea Bardan, Viorel Jinga, published by N.G. Lupu Internal Medicine Foundation
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

AHEAD OF PRINT
Previous article
Next article