Outcome studies on SGLT-2 inhibitors

Abstract

Inhibitors of sodium-glucose cotransporters type2 (SGLT-2) are aclass of oral antidiabetic drugs with anovel specific mode of action in the kidneys. The effects of SGLT-2 inhibitors on cardiovascular (CV) and renal endpoints in outcome trials with type2 diabetes patients. Differential analysis and interpretation of the results of outcome trials with the SGLT-2 inhibitors empagliflozin, canagliflozin and dapagliflozin in type2 diabetes mellitus. In the EMPA-REG OUTCOME trial, empagliflozin demonstrated asignificant reduction in major cardiac adverse events (MACE), hospitalization for heart failure (HHI), renal endpoints, CV and total mortality vs. placebo in >7000 patients with type2 diabetes and established CV disease over 3.1years. In the CANVAS program, canagliflozin demonstrated asignificant reduction of MACE, HHI and renal endpoints vs. placebo in >10,000 patients with type2 diabetes and high CV risk over 2.4years. In the CREDENCE trial, canagliflozin demonstrated asignificant reduction of acombined renal endpoint and CV endpoints vs. placebo in >4000 patients with type2 diabetes and established kidney disease with albuminuria over 2.6years. In the DECLARE-TIMI58 trial, dapagliflozin demonstrated asignificant reduction in acombined endpoint of CV death and HHI vs. placebo in >17,000 patients with type2 diabetes and established CV disease or with multiple CV risk factors over 3.1years. Outcome trials with SGLT-2 inhibitors have collectively demonstrated cardioprotective and nephroprotective effects in patients with type2 diabetes and high CV risk. The use of SGLT-2 inhibitors is recommended in current guidelines and consensus statements as primary combination partners for metformin in patients with type2 diabetes and established CV disease, high CV risk, heart failure or kidney disease.