Cardiorenal protection with SGLT2: Lessons from the cardiovascular outcome trials

Abstract

Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of drugs that were primarily developed for the treatment of type 2 diabetes mellitus. However, these agents have shown to provide additional beneficial effects. We will discuss three main topics regarding the use of SGLT2 inhibitors: noncardiovascular effects, cardiovascular benefits, and novel clinical indications. Multiple clinical trials and preliminary studies across varying disciplines have shown that these agents exhibit cardiorenal‐protective benefits, retinoprotective benefits, and may aid in weight loss without causing marked hypoglycemia. Therefore, these agents represent an avenue in clinical practice to manage comorbid conditions in the hyperglycemic patient. Because of their multifaceted effects and robust action, SGLT2 inhibitors represent therapy options for providers that not only provide beneficial clinical results but also reduce total patient drug burden.

Use of Sodium-Glucose Cotransporter-2 Inhibitors in Clinical Practice for Heart Failure Prevention and Treatment: Beyond Type 2 Diabetes. A Narrative Review

“…In clinical practice, SGLT-2is have been recognized as a “new HF remedy” for the management of patients with T2D and HF [ 17 ]. Moreover, there is speculation that because of their wide-ranging therapeutic effects, SGLT-2is may also prove useful for reducing medication burden, which is an important consideration in patients with multiple CV-related comorbidities requiring several therapeutic interventions [ 49 ].…”

Predictors of cardio-kidney complications and treatment failure in patients with chronic kidney disease and type 2 diabetes treated with SGLT2 inhibitors

“…There is an increasing need for new therapeutic agents that may slow or halt the progression of DKD and reduce the high morbidity and mortality in this population. Sodium-glucose co-transporter 2 inhibitors (SGLT2is), the most recently approved class of glucose-lowering agents for T2D in the US in March 2013, have later shown beneficial effects on kidney and cardiovascular outcomes and are recommended in clinical practice guidelines [ 9 , 10 ]. Notwithstanding the substantial clinical benefit of SGLT2is shown in clinical trials, real-life evidence on the remaining unmet need and treatment patterns among patients with DKD prescribed SGLT2is are scarce [ 11 , 12 ].…”