Abstract
Abstract BACKGROUND AND AIMS The use of iSGLT2 in people over 75 years was initially associated with a higher rate of adverse effects (AEs). Subsequent clinical trials have consistently demonstrated no increase of serious adverse effects in this group of patients, but the incidence of minor adverse events remains to be analysed in this group of patients The objective of this study is to evaluate in real life the incidence of adverse effects attributable to this family of drugs in patients aged 75 years (75+) or more at the beginning of treatment with iSGLT2 taking as reference population patients aged less than 75 years (<75). The incidence of cardiovascular events and death was also analysed. METHOD Observational study, one-centre. We selected all the patients undergoing iSGLT2 treatment at our centre since 2015 till 2021, grouping them according to their age at the start (75 + versus <75 years). RESULTS A total of 153 patients started treatment with iSGLT2 in our centre, 33 (21.6%) were 75 or older. Follow-up time was 19.0 months, interquartile range [8.9–30.3]. Mean age 67.3 years (SD 10.5), m: f ratio was 3:1 and type of SGLT2i was dapagliflozin 49%, canagliflozin 29% and empagliflozin 22%. A total of 28 patients (18.3%) had some side effect of the drug, without significant differences between + 75 and <75. The most frequent AEs in both groups were genitourinary (GU) infections (10.3%) and falls (9.2%), Eight patients discontinued treatment (five due to any AEs) with similar distribution in both groups. GU tract infections were more frequent in the first year of treatment treatment (100% during first year in 75+ and 46.7% in <75 years). We did not found any difference in older patients in the rate of CV events or death (Log rank 0.6) CONCLUSION Side effects of iSGLT2 were uncommon in our population, and age above 75 years was not associated with a higher incidence of AEs. GU tract infections, which were the most prevalent AE, were more frequent in the first year of treatment indicating the need of a more careful monitoring in this period of time.
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