Canagliflozin lowers blood sugar, but does it also lower cardiovascular risk? Maybe not

Heston, Thomas F; Olson, Anndres H.; Randall, Nicholas R.

doi:10.21037/atm.2017.09.28

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…As mentioned above, the basic evidence for favourable CV outcomes of SGLT2is (empagliflozin, canagliflozin and dapagliflozin) was obtained mainly in three randomised clinical trials: EMPA-REG OUTCOME, CANVAS and DECLARE-TIMI 58 [ 1 – 9 , 19 , 27 ]. These three clinical trials differed not only in the studied drug but also in relation to the studied patient population [ 27 ].…”

Section: Sglt2 Inhibition and Clinical Outcomesmentioning

confidence: 99%

“…A new group of antidiabetic drugs, sodium-glucose cotransporter 2 inhibitors (SGLT2is), has recently been shown to significantly improve the prognosis in high-risk cardiovascular (CV) patients with type 2 diabetes. The CV outcomes of SGLT2is (empagliflozin, canagliflozin and dapagliflozin) have been evaluated in, among others, three randomised clinical trials: Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), Canagliflozin Cardiovascular Assessment Study (CANVAS) and Dapagliflizin Effect on Cardiovascular Events Thrombosis in Myocardial Infarction 58 (DECLARE-TIMI 58) [1][2][3][4][5][6][7][8][9][10]. The first and thus groundbreaking EMPA-REG OUTCOME study showed that the use of empagliflozin in patients with type 2 diabetes and a high CV risk reduced CV mortality by 38%, without significantly reducing the number of non-fatal myocardial infarctions and strokes [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure

et al. 2020

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Diabetes is a key independent risk factor in the development of heart failure (HF) and a strong, adverse prognostic factor in HF patients. HF remains the primary cause of hospitalisation for diabetics and, as previous studies have shown, when HF occurs in these patients, intensive glycaemic control does not directly improve the prognosis. Recent clinical studies assessing a new class of antidiabetic drugs, sodium-glucose cotransporter 2 inhibitors (SGLT2is) showed some unexpected beneficial results. Patients treated with SGLT2is had a significant decrease in both cardiovascular (CV) and all-cause mortality and less hospitalisations due to HF compared to those given a placebo. These significant clinical benefits occurred quickly after the drugs were administered and were not solely due to improved glycaemic control. These groundbreaking clinical trials’ results have already changed clinical practice in the management of patients with diabetes at high CV risk. These trials have triggered numerous experimental studies aimed at explaining the mechanisms of action of this unique group of drugs. This article presents the current state of knowledge about the mechanisms of action of SGLT2is developed for the treatment of diabetes and which, thanks to their cardioprotective effects, may, in the future, become a treatment for patients with HF.

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Section: Sglt2 Inhibition and Clinical Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure

et al. 2020

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“…Their nephroprotective effect has also been confirmed both in patients with and without diabetes [ 21 , 22 ]. There have been many randomised clinical trials to assess the cardiovascular outcomes of SGLT-2 inhibitors (empagliflozin, canagliflozin and dapagliflozin), including the Canagliflozin Cardiovascular Assessment Study (CANVAS), the Dapagliflozin Effect on Cardiovascular Events Thrombosis in Myocardial Infarction 58 (DECLARE—TIMI 58) and the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 23 , 24 ]. These clinical trials have revealed that when SGLT-2 inhibitors were administered to patients there was a significant reduction in CV mortality.…”

Section: Introductionmentioning

confidence: 99%

SGLT-2 Inhibitors in Cancer Treatment—Mechanisms of Action and Emerging New Perspectives

Dutka

Bobiński

Francuz

et al. 2022

Cancers

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A new group of antidiabetic drugs, sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors), have recently been shown to have anticancer effects and their expression has been confirmed in many cancer cell lines. Given the metabolic reprogramming of these cells in a glucose-based model, the ability of SGLT-2 inhibitors to block the glucose uptake by cancer cells appears to be an attractive therapeutic approach. In addition to tumour cells, SGLT-2s are only found in the proximal tubules in the kidneys. Furthermore, as numerous clinical trials have shown, the use of SGLT-2 inhibitors is well-tolerated and safe in patients with diabetes and/or heart failure. In vitro cell culture studies and preclinical in vivo studies have confirmed that SGLT-2 inhibitors exhibit antiproliferative effects on certain types of cancer. However, the mechanisms of this action remain unclear. Even in those tumour cell types in which SGLT-2 is present, there is sometimes an SGLT-2-independent mechanism of anticancer action of this group of drugs. This article presents the current state of knowledge of the potential mechanisms of the anticancer action of SGLT-2 inhibitors and their possible future application in clinical oncology.

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Canagliflozin lowers blood sugar, but does it also lower cardiovascular risk? Maybe not

Cited by 2 publications

References 13 publications

Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure

Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure

SGLT-2 Inhibitors in Cancer Treatment—Mechanisms of Action and Emerging New Perspectives

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