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SGLT-2 inhibitors: new horizons for rheumatologists
Katherine Chakrabarti1, W Joseph McCune
1Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.
Current Opinion in Rheumatology
|July 15, 2024
Summary
Sodium glucose cotransporter 2 (SGLT2) inhibitors show promise for treating lupus nephritis, reducing proteinuria safely. Further research is needed to integrate these diabetes medications into rheumatology practice.
Area of Science:
- Nephrology
- Rheumatology
- Pharmacology
Background:
- Sodium glucose cotransporter 2 (SGLT2) inhibitors, initially for diabetes, offer significant cardiac and renal benefits.
- Their use in rheumatology is growing, especially for chronic kidney disease with proteinuria.
Purpose of the Study:
- To review the expanding role of SGLT2 inhibitors in rheumatology.
- To assess their efficacy and safety in autoimmune glomerulonephropathies, particularly lupus nephritis.
Main Methods:
- Review of recent clinical trials and studies on SGLT2 inhibitors.
- Analysis of data from large trials and smaller studies in specific autoimmune conditions.
Main Results:
- SGLT2 inhibitors are approved for type 2 diabetes, heart failure, cardiovascular disease, and proteinuric chronic kidney disease.
- Studies, including DAPA-CKD, demonstrate SGLT2 inhibition reduces renal disease progression in IgA nephropathy.
- Small studies indicate SGLT2 inhibitors improve proteinuria in lupus nephritis, with no safety concerns even with immunosuppression.
Conclusions:
- SGLT2 inhibitors show potential for safe and effective use in lupus nephritis.
- Further research is required to establish their definitive role in rheumatological treatment strategies.
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