EMPA-REG OUTCOME is recognised by international guidelines as a landmark study that showed a significant cardioprotective benefit with empagliflozin in patients with type 2 diabetes (T2D) and cardiovascular disease. To assess the impact of empagliflozin in routine clinical practice, the ongoing EMPRISE study is collecting real-world evidence to compare effectiveness, safety and health economic outcomes between empagliflozin and DPP-4 inhibitors. A planned interim analysis of EMPRISE was recently published, confirming a substantial reduction in hospitalisation for heart failure with empagliflozin across a diverse patient population. In this commentary article, we discuss the new data in the context of current evidence and clinical guidelines, as clinicians experienced in managing cardiovascular risk in patients with T2D. We also look forward to what future insights EMPRISE may offer, as evidence is accumulated over the next years to complement the important findings of EMPA-REG OUTCOME.

3rd Department of Internal Medicine 1st Faculty of Medicine Charles University Prague Prague Czech Republic

Carol Davila University of Medicine and Pharmacy Bucharest Romania

Clinic for Endocrinology Diabetes and Metabolic Diseases Clinical Centre of Serbia Faculty of Medicine University of Belgrade Belgrade Serbia

Clinic of Internal Diseases Family Medicine and Oncology Institute of Medicine Faculty of Medicine Vilnius University Hospital Santaros Klinikos Vilnius University Vilnius Lithuania

Department of Endocrinology Diabetes and Metabolic Diseases University Medical Centre Ljubljana Slovenia

Department of Internal Medicine 1 and CD Laboratory for Metabolic Crosstalk Medical University of Innsbruck Innsbruck Tirol Austria

Department of Internal Medicine 4 Faculty of Medicine Safarik University in Košice Košice Slovakia

Department of Medicine András Jósa Teaching Hospital Nyíregyháza Hungary

Diabetes and Endocrinology Clinic Clalit Medical Services Ramat Gan Israel

Estonian Diabetes Center Tallinn Estonia

Latvian Center of Cardiology Stradiņš Clinical University Hospital Rīga Stradiņš University Riga Latvia

Medical University of Silesia Katowice Poland

Medical University of Vienna Vienna Austria

National Medical Academy for Postgraduate Education Kiev Ukraine

Russian Medical Academy for Continuous Professional Education Ministry of Education of the Russian Federation Moscow Russia

School of Medicine University of Zagreb Vuk Vrhovac University Clinic UH Merkur Zagreb Croatia

Sheba Medical Center and Tel Aviv University Tel Aviv Israel

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