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Comparison of Effectiveness Among Different Sodium-Glucose Cotransoporter-2 Inhibitors According to Underlying

Ryoma Kani1, Atsuyuki Watanabe2, Yoshihisa Miyamoto3

  • 1Postgraduate Education Center, Kameda Medical Center Chiba Japan.

Journal of the American Heart Association
|January 31, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitors show similar efficacy in cardiovascular and kidney outcomes. Empagliflozin may offer benefits for patients without chronic kidney disease, but further research is needed.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used for managing type 2 diabetes and heart failure.
  • Individual efficacy and safety profiles of different SGLT2 inhibitors require detailed investigation across diverse patient populations.

Purpose of the Study:

  • To compare the individual profiles of various SGLT2 inhibitors in patients with different comorbidities.
  • To assess the efficacy and safety of empagliflozin, ertugliflozin, dapagliflozin, canagliflozin, and sotagliflozin.

Main Methods:

  • A meta-analysis of 21 placebo-controlled randomized controlled trials involving 96,196 participants.
  • Primary endpoint: composite of cardiovascular death and heart failure hospitalizations.
  • Subgroup analyses were performed based on diabetes and chronic kidney disease status.

Main Results:

  • No significant differences in the primary efficacy outcome were observed among SGLT2 inhibitors in the overall cohort.
  • Empagliflozin and dapagliflozin showed a lower risk of acute kidney injury compared to sotagliflozin.
  • In patients without chronic kidney disease, empagliflozin demonstrated a reduced risk of the primary outcome versus ertugliflozin.

Conclusions:

  • SGLT2 inhibitors demonstrated comparable efficacy in reducing cardiovascular and kidney outcomes, with no significant differences in safety profiles.
  • Empagliflozin may be a preferred choice for patients without chronic kidney disease.
  • Further research is warranted to elucidate the mechanisms and clinical effectiveness of individual SGLT2 inhibitors in specific patient groups.
Keywords:
CKDSGLT2 inhibitorscardiovascular death or hospitalizations for HFdiabetesnetwork meta‐analysis

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