SGLT2 Inhibitors in Patients with Chronic Kidney Disease and Heart Disease: A Literature Review

Kansara, Abhishek; Mubeen, Faiza; Shakil, Jawairia

doi:10.14797/mdcvj.1120

Cited by 9 publications

(4 citation statements)

References 64 publications

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“…SGLT2 inhibitors are generally considered safe; the most commonly reported adverse effects are infections of genitourinary tract, hypotension and diabetic ketoacidosis, which are associated to their mechanism of action [55]. Furthermore, SGLT2 inhibitors have recently been found to have cardio-and kidney-protective effects due to their antiphlogistic and antifibrotic mode of action, which has led to their marketing authorization for nondiabetic indications, namely heart failure and chronic kidney disease [56][57][58]. Reduction of inflammation, steatosis and fibrosis has been suggested as a beneficial effect on the liver, for which the clinical efficacy of SGLT2 inhibitors is being investigated in numerous RCTs (1,59,60).…”

Section: Sodium-glucose Cotransporter 2 (Sglt2) Inhibitorsmentioning

confidence: 99%

MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development

Khaznadar,

Petrovic

et al. 2024

Preprint

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With around one billion of the world's population affected, the era of Metabolic-associated fatty liver disease (MAFLD) pandemic has entered the global stage. MAFLD is a chronic progressive liver disease with accompanying metabolic disorders such as type 2 diabetes mellitus and obesity which can progress asymptomatically to liver cirrhosis and subsequently to hepatocellular carcinoma (HCC), and for which, to date there is almost no approved pharmacologic options. Because MAFLD has a very complex etiology and it affects also extrahepatic organs, a multidisciplinary approach is required when it comes to finding an effective and safe active substance for MAFLD treatment. The optimal drug for MAFLD should diminish steatosis, fibrosis and inflammation in the liver, and the winner for MAFLD drug authorisation seems to be the one that significantly improves liver histology. Saroglitazar (Lipaglyn®) was approved for Metabolic dysfunction associated steatohepatitis (MASH) in India in 2020; however, the drug is still being investigated in other countries. Despite that a pharmaceutical industry is still lagging behind to develop an ap-proved pharmacologic therapy for MAFLD, research has been recently intensified and many molecules which are underway in the final stages of clinical trials are expected to be approved in the coming few years. Already this year, the first drug (Rezdiffra™) in the United States was ap-proved via accelerated procedure for treatment of MAFLD, i.e. of MASH in adults. This review underscores the most recent information related to the development of drugs for MAFLD treatment, focusing on the molecules that have come furthest towards approval.

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Section: Sodium-glucose Cotransporter 2 (Sglt2) Inhibitorsmentioning

confidence: 99%

MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development

Khaznadar,

Petrovic

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…SGLT2 inhibitors are generally considered safe; the most commonly reported adverse effects are infections of the genitourinary tract, hypotension and diabetic ketoacidosis, which are associated with their mechanism of action [70]. Furthermore, SGLT2 inhibitors have recently been found to have cardio-and kidney-protective effects due to their antiphlogistic and antifibrotic mode of action, which has led to their marketing authorization for nondiabetic indications, namely heart failure and chronic kidney disease [71][72][73]. Reduction of inflammation, steatosis and fibrosis have been suggested as beneficial effects on the liver, for which the clinical efficacy of SGLT2 inhibitors is being investigated in numerous RCTs [1,74,75].…”

Section: Sodium-glucose Cotransporter 2 (Sglt2) Inhibitorsmentioning

confidence: 99%

MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development

Khaznadar,

Petrovic

et al. 2024

CIMB

View full text Add to dashboard Cite

With around one billion of the world’s population affected, the era of the metabolic-associated fatty liver disease (MAFLD) pandemic has entered the global stage. MAFLD is a chronic progressive liver disease with accompanying metabolic disorders such as type 2 diabetes mellitus and obesity which can progress asymptomatically to liver cirrhosis and subsequently to hepatocellular carcinoma (HCC), and for which to date there are almost no approved pharmacologic options. Because MAFLD has a very complex etiology and it also affects extrahepatic organs, a multidisciplinary approach is required when it comes to finding an effective and safe active substance for MAFLD treatment. The optimal drug for MAFLD should diminish steatosis, fibrosis and inflammation in the liver, and the winner for MAFLD drug authorisation seems to be the one that significantly improves liver histology. Saroglitazar (Lipaglyn®) was approved for metabolic-dysfunction-associated steatohepatitis (MASH) in India in 2020; however, the drug is still being investigated in other countries. Although the pharmaceutical industry is still lagging behind in developing an approved pharmacologic therapy for MAFLD, research has recently intensified and many molecules which are in the final stages of clinical trials are expected to be approved in the coming few years. Already this year, the first drug (Rezdiffra™) in the United States was approved via accelerated procedure for treatment of MAFLD, i.e., of MASH in adults. This review underscores the most recent information related to the development of drugs for MAFLD treatment, focusing on the molecules that have come furthest towards approval.

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“…Improvements of weight loss. SGLT-2 inhibition leads to caloric loss via glucosuria (average 270 kcal or 70 g glucose per day), which results in body weight reduction, increased insulin sensitivity, improved lipid metabolism and a decrease in lipotoxicity [20,31]. This shift in the substrate utilization from carbohydrates to lipids and ketone bodies, is considered to have cardio-and renoprotective effects.…”

Section: Metabolic Benefitsmentioning

confidence: 99%

New Directions in Pharmacological Treatment With SGLT-2 Inhibitor Molecules in the Light of Current Guidelines for Diabetes Mellitus, Heart Failure and Kidney Disease

TILINCA

2023

FARMACIA

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Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, a newer class of oral anti-hyperglycaemic agents, have been shown to improve cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM), by reducing the risk of heart failure, cardiovascular death, and renal events. This review aimed to describe the mechanism of action and clinical benefits of SGLT-2 inhibitors, highlighting their cardiorenal protection, glucose lowering effects, and their efficacy in the management of T2DM with multiple risk factors. SGLT-2 inhibitors reduce the reabsorption of sodium and glucose from the proximal tubules, thereby increasing renal glucose and sodium excretion. In addition to their glucose-lowering property, the clinical benefits of SGLT-2 inhibitors involve weight loss and major cardio-and reno-protective effects such as decreased preload and afterload, reversed cardiac remodelling, improved endothelial function, reduced albuminuria, improved glomerular hemodynamic and preserved kidney function. Therefore, SGLT2 inhibitors are a crucial component of management guidelines for diabetes, heart failure and chronic kidney disease, even in those without T2DM. RezumatInhibitorii co-transportorului 2 de sodiu-glucoză (SGLT-2), o nouă clasă de agenți antihiperglicemianți cu administrare orală, au demonstrat îmbunătățirea rezultatelor cardiovasculare și renale la pacienți cu diabet zaharat (DZ) tip 2, prin reducerea riscului de insuficiență cardiacă, deces de origine cardiovasculară și complicații renale. Acest articol își propune descrierea mecanismului de acțiune și a beneficiilor clinice ale inhibitorilor de SGLT-2, evidențiind efectele lor protectoare cardiorenale și de scădere a glicemiei, precum și eficacitatea lor în managementul DZ tip 2 cu multipli factori de risc. Inhibitorii de SGLT-2 reduc reabsorbția sodiului și glucozei din tubii contorți proximali, crescând astfel excreția renală de glucoză și sodiu. Pe lângă scăderea glicemiei, beneficiile clinice ale inhibitorilor de SGLT-2 includ scăderea în greutate și efecte cardio-și renoprotectoare, precum scăderea presarcinii și postsarcinii cardiace, inversarea remodelării cardiace majore, îmbunătățirea funcției endoteliale, reducerea albuminuriei, ameliorarea hemodinamicii glomerulare și menținerea funcției renale. Astfel, inhibitorii de SGLT-2 reprezintă un pilon extrem de important al ghidurilor de management, atât pentru diabetul zaharat, cât și pentru insuficiența cardiacă și boala renală cronică, chiar și la cei fără DZ tip 2.

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SGLT2 Inhibitors in Patients with Chronic Kidney Disease and Heart Disease: A Literature Review

Cited by 9 publications

References 64 publications

MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development

MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development

MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development

New Directions in Pharmacological Treatment With SGLT-2 Inhibitor Molecules in the Light of Current Guidelines for Diabetes Mellitus, Heart Failure and Kidney Disease

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