Bexagliflozin on Renal Outcomes in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized...

Area of Science:

• Nephrology
• Endocrinology
• Pharmacology

Background:

• Sodium-glucose cotransporter-2 (SGLT2) inhibitors are established treatments for type 2 diabetes mellitus (T2DM).
• The renal and urinary benefits of bexagliflozin, a newer SGLT2 inhibitor, require further investigation.

Purpose of the Study:

• To evaluate the efficacy of bexagliflozin on renal and urinary outcomes in patients with T2DM.
• To synthesize evidence from randomized controlled trials (RCTs) regarding bexagliflozin's impact on kidney function.

Main Methods:

• A systematic review and meta-analysis of RCTs were conducted using data from ClinicalTrials.gov, PubMed, Embase, and Cochrane databases.
• A random-effects model was utilized to calculate mean differences and risk ratios for continuous and binary endpoints.
• The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

Main Results:

• Nine studies with 4,352 patients were analyzed, with follow-up periods ranging from 12 to 96 weeks.
• Bexagliflozin treatment did not result in significant changes in serum creatinine (MD: 0.05 mg/dL) or estimated glomerular filtration rate (eGFR) (MD: -0.43 mL/min/1.73 m²).
• A significant reduction in systolic blood pressure was observed in the bexagliflozin group (MD: -4.2 mmHg).

Conclusions:

• Bexagliflozin demonstrated no beneficial effect on kidney function in large placebo-controlled trials, consistent with other SGLT2 inhibitors.
• While bexagliflozin effectively reduced systolic blood pressure, its impact on renal outcomes requires further study.
• The findings suggest that bexagliflozin's primary role may not be in direct renal protection for T2DM patients.