Sex differences in cardiovascular outcomes of SGLT-2 inhibitors in heart failure randomized controlled trials: A systematic review and meta-analysis

Rivera, Frederick Berro; Tang, Vincent Anthony S.; Luna, Deogracias Villa De; Lerma, Edgar V.; Vijayaraghavan, Krishnaswami; Kazory, Amir; Shah, Nilay S.; Volgman, Annabelle Santos

doi:10.1016/j.ahjo.2023.100261

Cited by 11 publications

(7 citation statements)

References 33 publications

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“…Although it is well-known that the risk of developing CVD is higher in women with type 2 DM than in men, GLP-1RAs remain effective in improving CV outcomes regardless of sex [ 26 ]. Regardless, women remain underrepresented in CVOTs [ [27] , [28] , [29] ] and those with T2DM present with worse metabolic control, hence the need for guidelines and policies to optimize DM therapy specific to both male and female sex [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: A meta-analysis of randomized placebo-controlled trials

Rivera,

Cruz,

Magalong

et al. 2024

American Journal of Preventive Cardiology

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Section: Discussionmentioning

confidence: 99%

Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: A meta-analysis of randomized placebo-controlled trials

Rivera,

Cruz,

Magalong

et al. 2024

American Journal of Preventive Cardiology

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“…However, the reporting is still insufficient. A recent example is SGLT-2 inhibitors clinical trials, including around 35% women, with a discrepancy to the disease prevalence of HFpEF and lacking sex analyses [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Sex and gender differences in drug treatment: experiences from the knowledge database Janusmed Sex and Gender

Lind¹,

Rydberg

Schenck‐Gustafsson

2023

Biol Sex Differ

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Background Evidence from clinical research indicates that men and women can differ in response to drug treatment. The knowledge database Janusmed Sex and Gender was developed to illuminate potential sex and gender differences in drug therapy and, therefore, achieve a better patient safety. The database contains non-commercial evidence-based information on drug substances regarding sex and gender aspects in patient treatment. Here, we describe our experiences and reflections from collecting, analyzing, and evaluating the evidence. Janusmed Sex and Gender Substances have been systematically reviewed and classified in a standardized manner. The classification considers clinically relevant sex and gender differences based on available evidence. Mainly biological sex differences are assessed except for gender differences regarding adverse effects and compliance. Of the 400 substances included in the database, clinically relevant sex differences were found for 20%. Sex-divided data were missing for 22% and no clinically relevant differences were found for more than half of the substances (52%). We noted that pivotal clinical studies often lack sex analyses of efficacy and adverse effects, and post-hoc analyzes are performed instead. Furthermore, most pharmacokinetic analyses use weight correction, but medicines are often prescribed in standard doses. In addition, few studies have sex differences as a primary outcome and some pharmacokinetic analyses are unpublished, which may complicate the classification of evidence. Conclusions Our work underlines the need of sex and gender analyses, and sex-divided data in drug treatment, to increase the knowledge about these aspects in drug treatment and contribute to a more individualized patient treatment.

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“…Unsurprisingly, a number of drugs that aim to restore metabolism are in development, and a few are in clinical trials including nicotinamide riboside and dapaglifozin, which are designed to improve mitochondrial function and reduce blood glucose by inhibiting the sodium-glucose co-transporter-2 (SGLT2). There is some evidence suggesting that SGLT2 may exert sex-specific effects ( Rivera et al, 2023 ).…”

Section: Is There Evidence Of Sex-related Differences In Response To ...mentioning

confidence: 99%

A case for seeking sex-specific treatments in Alzheimer’s disease

Lynch

2024

Front. Aging Neurosci.

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There is no satisfactory explanation for the sex-related differences in the incidence of many diseases and this is also true of Alzheimer’s disease (AD), where females have a higher lifetime risk of developing the disease and make up about two thirds of the AD patient population. The importance of understanding the cause(s) that account for this disproportionate distribution cannot be overestimated, and is likely to be a significant factor in the search for therapeutic strategies that will combat the disease and, furthermore, potentially point to a sex-targeted approach to treatment. This review considers the literature in the context of what is known about the impact of sex on processes targeted by drugs that are in clinical trial for AD, and existing knowledge on differing responses of males and females to these drugs. Current knowledge strongly supports the view that trials should make assessing sex-related difference in responses a priority with a focus on exploring the sex-stratified treatments.

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Sex differences in cardiovascular outcomes of SGLT-2 inhibitors in heart failure randomized controlled trials: A systematic review and meta-analysis

Cited by 11 publications

References 33 publications

Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: A meta-analysis of randomized placebo-controlled trials

Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: A meta-analysis of randomized placebo-controlled trials

Sex and gender differences in drug treatment: experiences from the knowledge database Janusmed Sex and Gender

A case for seeking sex-specific treatments in Alzheimer’s disease

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