In a nutshell
The aim of this study was to investigate the effect of SGLT2 inhibitors on the prevention of heart and kidney disease in patients with type 2 diabetes (T2D). The main outcome was that SGLT2-inhibitors reduced hospitalization for heart failure and prevented the worsening of kidney disease in T2D.
Some background
There are many complications of T2D. These include heart and kidney disease. In particular, patients with T2D have an increased rate of atherosclerosis (ATS). This is a build-up of plaque in the blood vessels in the body. These plaques result in high blood pressure and increased risk of major cardiac events (heart attack, stroke, death).
SGLT2 inhibitors (SGLT2i) are drugs used in the treatment of T2D. They work by blocking the uptake of sugar in the kidney back into the blood. Instead, the sugar gets removed from the body in the urine. Some SGLT2i include canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance). The effect of SGLT2i on preventing heart and kidney disease in patients with T2D is still under investigation.
Methods & findings
This study included data from 3 trials with 34,322 patients. 60.2% of these patients already had established ATS before treatment with SGLT2i.
SGLT2i reduced major cardiac events by 11%. However, this benefit was only seen in patients who already had ATS. SGLT2i also decreased the rate of hospitalization due to heart failure by 23%. This was seen in both patients with and without ATS. SGLT2i also prevented the worsening of kidney disease by 45% in patients with and without ATS.
The bottom line
The authors concluded that SGLT2i decreased the rate of major cardiac events only in patients with ATS. However, SGLT2i decreased the hospitalization for heart failure and prevented kidney disease worsening in both patients with and without ATS.
Published By :
Lancet (London, England)
Date :
Nov 09, 2018
