Narrative Review of Immunomodulatory and Anti-inflammatory Effects of Sodium-Glucose Cotransporter 2 Inhibitors: Unveiling Novel Therapeutic Frontiers

Lee, Sul A.; Riella, Leonardo V.

doi:10.1016/j.ekir.2024.02.1435

Kidney International Reports

2024

DOI: 10.1016/j.ekir.2024.02.1435

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Narrative Review of Immunomodulatory and Anti-inflammatory Effects of Sodium-Glucose Cotransporter 2 Inhibitors: Unveiling Novel Therapeutic Frontiers

Sul A. Lee,

Leonardo V. Riella

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2024

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Cited by 2 publications

References 125 publications

(144 reference statements)

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Activating the Flozin Shield: Cardioprotective Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Kidney Transplant Recipients With Diabetes Mellitus

Penmatsa,

Muthukumar

2024

Kidney International Reports

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Activating the Flozin Shield: Cardioprotective Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Kidney Transplant Recipients With Diabetes Mellitus

Penmatsa,

Muthukumar

2024

Kidney International Reports

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Dulaglutide and Dapagliflozin Combination Concurrently Improves the Endothelial Glycocalyx and Vascular and Myocardial Function in Patients with T2DM and Albuminuria vs. DPP-4i

Korakas,

Thymis,

Oikonomou

et al. 2024

JCM

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Background: The association between diabetic nephropathy and arterial elasticity and endothelial function is well established. In this study, we compared the effect of the combination of dulaglutide and dapagliflozin versus DPP-4 inhibitors on the endothelial glycocalyx, arterial stiffness, myocardial function, and albuminuria. Methods: Overall, 60 patients were randomized to combined dulaglutide and dapagliflozin treatment (n = 30) or DPP-4 inhibitors (DPP-4i, n = 30) (ClinicalTrials.gov: NCT06611904). We measured at baseline and 4 and 12 months post-treatment: (i) the perfused boundary region of the sublingual arterial microvessels, (ii) pulse wave velocity (PWV) and central systolic blood pressure (cSBP), (iii) global left ventricular longitudinal strain (GLS), and (iv) urine albumin-to-creatinine ratio (UACR). Results: After twelve months, dual therapy showed greater improvements vs. DPP-4i in PBR (2.10 ± 0.31 to 1.93 ± 0.23 μm vs. 2.11 ± 0.31 to 2.08 ± 0.28 μm, p < 0.001), UACR (326 ± 61 to 142 ± 47 mg/g vs. 345 ± 48 to 306 ± 60 mg/g, p < 0.01), and PWV (11.77 ± 2.37 to 10.7 ± 2.29 m/s vs. 10.64 ± 2.44 to 10.54 ± 2.84 m/s, p < 0.001), while only dual therapy showed improvement in cSBP (130.21 ± 17.23 to 123.36 ± 18.42 mmHg). These effects were independent of glycemic control. Both treatments improved GLS, but the effect of dual therapy was significantly higher compared to DPP-4i (18.19% vs. 6.01%, respectively). Conclusions: Twelve-month treatment with dulaglutide and dapagliflozin showed a greater improvement in arterial stiffness, endothelial function, myocardial function, and albuminuria than DPP-4is. Early initiation of combined therapy as an add-on to metformin should be considered in these patients.

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Narrative Review of Immunomodulatory and Anti-inflammatory Effects of Sodium-Glucose Cotransporter 2 Inhibitors: Unveiling Novel Therapeutic Frontiers

Cited by 2 publications

References 125 publications

Activating the Flozin Shield: Cardioprotective Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Kidney Transplant Recipients With Diabetes Mellitus

Activating the Flozin Shield: Cardioprotective Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Kidney Transplant Recipients With Diabetes Mellitus

Dulaglutide and Dapagliflozin Combination Concurrently Improves the Endothelial Glycocalyx and Vascular and Myocardial Function in Patients with T2DM and Albuminuria vs. DPP-4i

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