Empagliflozin in South Asians with type 2 diabetes: Real world data on effects on cardiometabolic parameters, safety and determinants of response to therapy from a diabetes practice in Sri Lanka

Dissanayake, Harsha; Dilrukshi, Shani Apsara; Ratnasamy, Vithiya; Soysa, Pasindu; Samarathunga, Thilina; Bandara, Prabhath; Silva, Laksara De; Katulanda, Prasad

doi:10.1016/j.pcd.2022.11.005

Cited by 2 publications

(2 citation statements)

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“…Previous studies suggested that SGLT2 inhibitors are associated with a range of adverse events, 11 , 52 which can negatively affect the quality of life of SGLT2 inhibitor users and can lead to treatment discontinuation. 21 , 22 Our findings were consistent with a previous study that showed that genital infection was a common adverse event associated with the use of SGLT2 inhibitors. 16 However, among the studied SGLT2 inhibitors, sotagliflozin was associated with the lowest point estimate of genital infections, which was also in line with another meta‐analysis.…”

Section: Discussionsupporting

confidence: 91%

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Comparison of Effectiveness Among Different Sodium‐Glucose Cotransoporter‐2 Inhibitors According to Underlying Conditions: A Network Meta‐Analysis of Randomized Controlled Trials

Kani,

Watanabe,

Miyamoto

et al. 2024

JAHA

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Background To investigate the individual profile of each SGLT2 (sodium‐glucose cotransoporter‐2) inhibitor in patients with different backgrounds. Methods and Results This study included 21 placebo‐controlled randomized controlled trials with a total of 96 196 participants, investigating empagliflozin, ertugliflozin, dapagliflozin, canagliflozin, and sotagliflozin. The primary efficacy end point was the composite of cardiovascular death and hospitalizations for heart failure. The secondary efficacy end points were all‐cause death, cardiovascular death, hospitalizations for heart failure, kidney disease progression, and acute kidney injury. We conducted subgroup analyses based on the underlying comorbidities, including diabetes and chronic kidney disease. Safety end points were also assessed among SGLT2 inhibitors in the overall cohort. In the overall cohort, there were no significant differences in the primary efficacy outcome among the SGLT2 inhibitors, while empagliflozin (hazard ratio [HR], 0.70 [95% CI, 0.53–0.92]) and dapagliflozin (HR, 0.73 [95% CI, 0.56–0.96]) were associated with lower risk of acute kidney injury than sotagliflozin. The presence or absence of diabetes did not alter the results. In patients with chronic kidney disease, there were no differences in the efficacy outcomes among SGLT2 inhibitors, while in patients without chronic kidney disease, empagliflozin was associated with lower risk of the primary outcome compared with ertugliflozin (HR, 0.77 [95% CI, 0.60–0.98]). For safety outcomes, no significant differences were observed in amputation, urinary tract infection, genital infection, hypoglycemia, and diabetic ketoacidosis. Conclusions The differences in reducing cardiovascular and kidney outcomes as well as safety profiles across SGLT2 inhibitors were not consistently significant, although empagliflozin might be preferred in patients without chronic kidney disease. Further investigations are needed to better understand the mechanism and clinical effectiveness of each SGLT2 inhibitor in certain populations.

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Section: Discussionsupporting

confidence: 91%

“…However, proper selection remains uncertain without the comparative safety evidence. Because adverse events of SGLT2 inhibitors, such as genital infection, urinary tract infection (UTI), and hypovolemia, can lead to treatment discontinuation, 21 , 22 the comparative safety profiles should be investigated.…”

mentioning

confidence: 99%