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Effects of Sodium-Glucose Cotransporter 2 on Amputation Events: A Systematic Review and Meta-Analysis of

Ray Meng See1, Yao Neng Teo2, Yao Hao Teo2

  • 1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, e0253378@u.nus.edu.

Pharmacology
|December 23, 2021
PubMed
Abstract

Insights

This meta-analysis found no significant increase in amputation events with sodium-glucose cotransporter 2 (SGLT2) inhibitors. The study reviewed 15 randomized controlled trials, concluding SGLT2 inhibitors are safe regarding amputation risk.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are widely used for diabetes mellitus management, offering additional therapeutic benefits beyond glycemic control.
  • Concerns regarding potential complications, such as amputation events, have been raised, particularly following findings from the Canagliflozin Cardiovascular Assessment Study (CANVAS) trial.
  • This systematic review and meta-analysis aimed to rigorously evaluate the association between SGLT2 inhibitors and amputation events.

Approach:

  • A comprehensive search of four major electronic databases (PubMed, Embase, Cochrane, SCOPUS) was conducted up to November 21, 2020.
  • Included were 15 randomized-controlled trials encompassing a total of 63,716 patients.
  • Data were synthesized using random-effect pair-wise meta-analysis for hazard ratios and fixed-effect Peto odds ratio meta-analysis.

Key Points:

  • The meta-analysis revealed no statistically significant difference in amputation events among patients treated with SGLT2 inhibitors.
  • This finding remained consistent across various types of SGLT2 inhibitors, diverse baseline patient populations, and different durations of treatment.
  • The overall evidence suggests a neutral effect of SGLT2 inhibitors on the risk of amputation.

Conclusions:

  • Based on the available randomized-controlled trial data, SGLT2 inhibitors are not associated with an increased risk of amputation events.
  • The findings contribute to a clearer understanding of the safety profile of SGLT2 inhibitors concerning limb-related complications.
  • Further research may explore specific patient subgroups or long-term outcomes, but current evidence supports their safety in this regard.
Keywords:
AmputationsSodium-glucose cotransporter 2 inhibitors

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