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Study highlights positive cardiovascular and renal outcomes of SGLT2 Inhibitors in type 2 diabetes

By Editor
12th February 2018
Pharmaceutical, Type 2 diabetes

SGLT2 inhibitors showed “remarkable” cardiovascular and renal‐protective effects and “good” long‐term non-cardiovascular safety with sustained efficacy in type 2 diabetes, a summary of available evidence has suggested.

A systemic review and meta-analysis with trial sequential analysis was carried out into the cardiovascular and long‐term, non-cardiovascular safety and efficacy of SGLT2 inhibitors.

According to findings published in the Journal of the American Heart Association, trial sequential analysis provided firm evidence of a 20 per cent reduction in major adverse cardiac events, all‐cause mortality, and hospitalisation for heart failure with SGLT2 inhibitors, but evidence remains inconclusive for cardiovascular mortality.

Nine randomized controlled trials contributed to long‐term, non-cardiovascular and efficacy analyses, the researchers said.

SGLT2 inhibitors reduced incidence of hypoglycaemia and acute kidney injury but increased the risks of urinary tract and genital infections, the study concluded.

For cardiovascular outcomes, the researchers performed a meta‐analysis with trial sequential analysis of randomized controlled trials and adjusted observational studies, each with a minimum of 26 weeks and 2,000 patient‐years of follow‐up.

For long‐term, non-cardiovascular safety and efficacy outcome analyses, they included only randomized controlled trials with at least two years and 1,000 patient‐years of follow‐up. Five studies with 351 476 patients were included in cardiovascular outcomes analysis.

Summarising the results, the researchers said: “Meta‐analyses showed that SGLT2 inhibitors significantly reduced the risks of major adverse cardiac events (hazard ratio [HR]: 0.80; 95% confidence interval [CI], 0.69–0.92; P=0.002), all‐cause mortality (HR: 0.67; 95% CI, 0.54–0.84; P<0.001), cardiovascular mortality (HR: 0.77; 95% CI, 0.60–0.98; P=0.03), nonfatal myocardial infarction (HR: 0.86; 95% CI, 0.76–0.98; P=0.02), hospitalization for heart failure (HR: 0.62; 95% CI, 0.55–0.69; P<0.001), and progression of albuminuria (HR: 0.68; 95% CI, 0.58–0.81; P<0.001). No significant difference in nonfatal stroke was found. Analyses limited to randomized controlled trials showed similar findings.”

The researchers concluded: “Our meta‐analysis provides robust reassurance regarding the cardiovascular and long‐term noncardiovascular safety of SGLT2 inhibitors, with sustained efficacy in reducing a range of markers of vascular risk. SGLT2 inhibitors showed remarkable cardiovascular and renal protective benefits and might be considered as preferred for type 2 DM patients with established or high risk for CVD.”

To view the study, click here.

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