SGLT2 inhibitors associated with consistent cardiovascular benefits

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are consistently effective at reducing hospitalization for heart failure (HHF) and improving kidney disease outcomes, according to a new meta-analysis published in JAMA Cardiology.

The authors explored data from six randomized, placebo-controlled trials exploring the effect of SGLT2 inhibitors on patients with type 2 diabetes. Nearly 47,000 unique patients participated in one of the six trials, which were all completed from Jan. 1, 2015, to Jan. 31, 2020. The mean patient age was just shy of 64 years old, and nearly 66% were men.

Overall, SGLT2 inhibitors were found to be associated with “a reduced risk of major adverse cardiovascular events,” HHF/cardiovascular death and kidney outcomes. The risk reduction related to HHF was consistent across all six trials. On the other hand, the association between these medication and major adverse cardiovascular events (MACEs) seemed to only occur with empagliflozin and canagliflozin. Also, empagliflozin is the drug most associated with a reduction in cardiovascular death.

“The present results augment the growing evidence base that SGLT2 inhibitors in general are associated with favorable CV and kidney outcomes; in addition, the present study refines understanding of important differences in outcomes associated with drugs within the class,” wrote lead author Darren K. McGuire, MD, MHSc, University of Texas Southwestern Medical Center, and colleagues.

The team also noted that the safety profile of these medications is “firmly established,” and the most common adverse side effect was mycotic genital infections. These infections were “typically mild,” however, and “most often treated with over-the-counter therapies.”

Read the full assessment here.