Evidence map›Paper›PMID 33004464›Full record

Trial reportDiabetes care2020

The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial.

Ian J Neeland, Bjorn Eliasson, Takatoshi Kasai, Nikolaus Marx, Bernard Zinman, Silvio E Inzucchi, Christoph Wanner, Isabella Zwiener, Brian S Wojeck, Henry K Yaggi and 2 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Diabetes care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 1 pooled it
5.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Obstructive sleep apnoea is associated with accelerated progression of diabetic kidney disease.Diabetic medicine : a journal of the British Diabetic Association · 2026
    Article
  6. Review
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Pharmacological management of sleep apnea and obesity, a new frontier.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Article
  13. Evaluating the potential of metabolic drugs in obstructive sleep apnea and obesity: a narrative review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Review
  14. A Structured Narrative Review of the OSA-T2DM Axis.Journal of clinical medicine · 2025
    Review
  15. Review
  16. Review
  17. Review
  18. Article
  19. Article
  20. Tofogliflozin reduces sleep apnea severity in patients with type 2 diabetes mellitus and heart failure: a prospective study.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 6 countries.

Ian J NeelandUniversity Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine, Cleveland, OH ian.neeland@uhhospitals.org.ORCID 0000-0003-2831-3618
Bjorn EliassonDepartment of Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID 0000-0003-2569-4160
Takatoshi KasaiDepartment of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Nikolaus MarxDepartment of Internal Medicine I (Cardiology), RWTH University Hospital, Aachen, Germany.ORCID 0000-0001-6141-634X
Bernard ZinmanLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-0041-1876
Silvio E InzucchiSection of Endocrinology, Yale School of Medicine, Yale University, New Haven, CT.ORCID 0000-0003-1254-6636
Christoph WannerDepartment of Medicine, Wuerzburg University Clinic, Wuerzburg, Germany.ORCID 0000-0001-9507-5301
Isabella ZwienerBoehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany.
Brian S WojeckSection of Endocrinology, Yale School of Medicine, Yale University, New Haven, CT.
Henry K YaggiSection of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, CT.
Odd Erik Johansen
EMPA-REG OUTCOME Investigators
Yale University · USBoehringer Ingelheim (Germany) · DEBoehringer Ingelheim (Norway) · NOJuntendo University · JPMount Sinai Hospital · CASahlgrenska University Hospital · SESocial Neuroscience Lab · DEUniversitätsklinikum Aachen · DEUniversity Hospitals of Cleveland · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Diabetes Research CenterP30DK045735 · NIDDK · YALE UNIVERSITY · PI GERALD I SHULMAN · 1993 to 2026
$44.0M
DIABETES MELLITUS &DISORDERS OF METABOLISMT32DK007058 · NIDDK · YALE UNIVERSITY · PI SONIA CAPRIO, Kevan C Herold · 1986 to 2026
$9.6M
Visceral Adiposity and Diabetes: Translating Form to Function Using ImagingK23DK106520 · NIDDK · UT SOUTHWESTERN MEDICAL CENTER · PI NEELAND, IAN JASON · 2015 to 2019
$776k
Mentoring in Sleep Research and Sleep Interventions in Heart Disease, and StrokeK24HL132093 · NHLBI · YALE UNIVERSITY · PI YAGGI, HENRY KLAR · 2016 to 2020
$336k
NCATS NIH HHS UL1 TR001863NHLBI NIH HHS K24 HL132093NIDDK NIH HHS K23 DK106520NIDDK NIH HHS P30 DK045735NIDDK NIH HHS T32 DK007058
6 · The paper itself

Abstract

objectiveTo explore the effects of empagliflozin on the incidence of obstructive sleep apnea (OSA) and its effects on metabolic, cardiovascular (CV), and renal outcomes among participants with or without OSA in the EMPA-REG OUTCOME trial. RESEARCH DESIGN AND

methodsParticipants with diabetes and CV disease were randomized to empagliflozin (10 and 25 mg) or placebo daily in addition to standard of care. OSA was assessed by investigator report using Medical Dictionary for Regulatory Activities version 18.0, and CV outcomes were independently adjudicated. Analyses were performed using multivariable-adjusted Cox regression models.

resultsOSA was reported in 391 of 7,020 (5.6%) participants at baseline. Those with OSA were more likely to be male (83% vs. 71%) and to have moderate to severe obesity (BMI ≥35 kg/m

conclusionsIn EMPA-REG OUTCOME, participants with OSA had greater comorbidity and higher frequency of CV and renal events. Empagliflozin had favorable effects on risk factors and CV and renal outcomes regardless of preexisting OSA and may also reduce the risk for new-onset OSA.

Indexed as

AgedBenzhydryl CompoundsCardiovascular DiseasesCardiovascular SystemComorbidityDiabetes Mellitus, Type 2FemaleFollow-Up StudiesGlucosidesHumansIncidenceKidney DiseasesMaleMiddle AgedPrevalenceRisk FactorsBenzhydryl CompoundsempagliflozinGlucosides

Identifiers

PMID33004464
PMCPMC7770278
OpenAlexW3091412683

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.