Sodium glucose co-transport 2 inhibitors for gout treatment

Somagutta, Manoj Reddy; Luvsannyam, Enkhmaa; Jain, Molly S; Cuddapah, Gaurav Venkat; Pelluru, Sandeep; Mustafa, Nafisa; Nasereldin, Duaa; Pendyala, Siva K; Jarapala, Nagendrababu; Padamati, Bhavani

doi:10.15190/d.2022.11

Cited by 7 publications

(4 citation statements)

References 44 publications

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“…A novel approach of using Sodium-Glucose Cotransporter 2 (SGLT-2) inhibitors to lower uric acid was suggested, and this effect was proposed as one of the possible components of SGLT-2 inhibitors' pleiotropic effects on cardiovascular diseases by antiinflammatory actions [41]. The SGLT-2 inhibitors alone were found to significantly decrease sUA levels in patients with diabetes mellites [42]. Furthermore, combining the SGLT-2 inhibitors with sUA-lowering medications showed an additive effect [42].…”

Section: Discussionmentioning

confidence: 99%

“…The SGLT-2 inhibitors alone were found to significantly decrease sUA levels in patients with diabetes mellites [42]. Furthermore, combining the SGLT-2 inhibitors with sUA-lowering medications showed an additive effect [42]. The doubleblind prospective studies involving the effect of SGLT-2 inhibitors on cardiovascular risk in patients with hyperuricemia alone or combined with hypertension should be performed.…”

Section: Discussionmentioning

confidence: 99%

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Hyperuricemia as a Risk Factor in Hypertension among Patients with Very High Cardiovascular Risk

Muszyński,

Dąbrowski,

Pasławska

et al. 2023

Healthcare

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Hypertension remains a global threat to public health, affecting the worldwide population. It is one of the most common risk factors for cardiovascular disease. Today’s treatments focus on creating a hypotensive effect. However, there is a constant search for additional factors to reduce the potential of developing hypertension complications. These factors may act as a parallel treatment target with a beneficial effect in specific populations. Some studies suggest that uric acid may be considered such a factor. This study investigated the potential effect of uric acid concentrations over 5 mg/dL on the incidence of hypertension complications among patients with very high cardiovascular risk. A total of 705 patients with hypertension and very high cardiovascular risk were selected and included in the analysis. The patients were divided and compared according to serum uric acid levels. The study showed a higher occurrence of heart failure (OR = 1.7898; CI: 1.2738–2.5147; p = 0.0008), atrial fibrillation (OR = 3.4452; CI: 1.5414–7.7002; p = 0.0026) and chronic kidney disease (OR = 2.4470; CI: 1.3746–4.3558; p = 0.0024) among individuals with serum uric acid levels over 5 mg/dL, males and those with a BMI > 25 kg/m2. These findings suggest that even serum uric acid concentrations over 5 mg/dL may affect the prevalence of hypertension-related complications among patients with very high cardiovascular risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hyperuricemia as a Risk Factor in Hypertension among Patients with Very High Cardiovascular Risk

Muszyński,

Dąbrowski,

Pasławska

et al. 2023

Healthcare

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“…It is necessary to know the interactions between all biochemical processes, the chronology of all changes, and their correlation with the cardiovascular benefits of gliflozin therapy [101]. The potential mechanisms [31] are diuresis and natriuresis, changes in myocardial energetics, increased erythropoietin (EPO) production and erythropoiesis, changes in renocardiac signaling, inhibition of the sympathetic nervous system, inhibition of the Na + /H + Exchanger-1 (NHE1), inhibition of the NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome, potential vascular effects, and reducing uric acid levels in serum [102].…”

Section: Heart Protectionmentioning

confidence: 99%

Risks and Benefits of SGLT-2 Inhibitors for Type 1 Diabetes Patients Using Automated Insulin Delivery Systems—A Literature Review

Elian,

Popovici,

Karampelas

et al. 2024

IJMS

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The primary treatment for autoimmune Diabetes Mellitus (Type 1 Diabetes Mellitus-T1DM) is insulin therapy. Unfortunately, a multitude of clinical cases has demonstrated that the use of insulin as a sole therapeutic intervention fails to address all issues comprehensively. Therefore, non-insulin adjunct treatment has been investigated and shown successful results in clinical trials. Various hypoglycemia-inducing drugs such as Metformin, glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, amylin analogs, and Sodium-Glucose Cotransporters 2 (SGLT-2) inhibitors, developed good outcomes in patients with T1DM. Currently, SGLT-2 inhibitors have remarkably improved the treatment of patients with diabetes by preventing cardiovascular events, heart failure hospitalization, and progression of renal disease. However, their pharmacological potential has not been explored enough. Thus, the substantial interest in SGLT-2 inhibitors (SGLT-2is) underlines the present review. It begins with an overview of carrier-mediated cellular glucose uptake, evidencing the insulin-independent transport system contribution to glucose homeostasis and the essential roles of Sodium-Glucose Cotransporters 1 and 2. Then, the pharmacological properties of SGLT-2is are detailed, leading to potential applications in treating T1DM patients with automated insulin delivery (AID) systems. Results from several studies demonstrated improvements in glycemic control, an increase in Time in Range (TIR), a decrease in glycemic variability, reduced daily insulin requirements without increasing hyperglycemic events, and benefits in weight management. However, these advantages are counterbalanced by increased risks, particularly concerning Diabetic Ketoacidosis (DKA). Several clinical trials reported a higher incidence of DKA when patients with T1DM received SGLT-2 inhibitors such as Sotagliflozin and Empagliflozin. On the other hand, patients with T1DM and a body mass index (BMI) of ≥27 kg/m2 treated with Dapagliflozin showed similar reduction in hyperglycemia and body weight and insignificantly increased DKA incidence compared to the overall trial population. Additional multicenter and randomized studies are required to establish safer and more effective long-term strategies based on patient selection, education, and continuous ketone body monitoring for optimal integration of SGLT-2 inhibitors into T1DM therapeutic protocol.

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“…Dis. 2024, 2 158 and can lead to secondary skeletal malformations and increase the risk of cardiovascular disease [10]. Urate-lowering therapy (ULT) is a critical component in treating gout patients and includes xanthine oxidase inhibitors (Allopurinol and Febuxostat), drugs that block the upstream enzyme responsible for uric acid formation [11].…”

Section: Introductionmentioning

confidence: 99%

SGLT2 Inhibitors and Uric Acid Homeostasis

Zapf,

Woodward

2024

GUCDD

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A relationship between metabolic disorders and hyperuricemia is well established. The nature of the relationship—risk factor, causal agent, or byproduct—remains unclear. Recent studies of sodium–glucose transporter 2 inhibitors (SGLT2i’s) have established that this pharmacological intervention is beneficial to patients with hyperglycemia and type 2 diabetes mellitus (T2D) and also against the common cardio and renal comorbidities associated with diabetes. Hyperuricemia, or high plasma uric acid levels, is one of the comorbidities mitigated with SGLT2i treatment, raising the potential for using SGLT2i’s as part of the treatment for gout and hyperuricemia. However, the mechanisms underlying the lower plasma urate levels and increased uricosuria produced with SGLT2i’s remains poorly understood. Here, we review the renal physiology of glucose and uric acid transport, the renal consequences of hyperglycosuria and diabetes, the benefits and physiology of SGLT2i use, and discuss several potential mechanisms that may be responsible for the favorable uricosuric effect observed in those treated with SGLT2i’s.

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Sodium glucose co-transport 2 inhibitors for gout treatment

Cited by 7 publications

References 44 publications

Hyperuricemia as a Risk Factor in Hypertension among Patients with Very High Cardiovascular Risk

Hyperuricemia as a Risk Factor in Hypertension among Patients with Very High Cardiovascular Risk

Risks and Benefits of SGLT-2 Inhibitors for Type 1 Diabetes Patients Using Automated Insulin Delivery Systems—A Literature Review

SGLT2 Inhibitors and Uric Acid Homeostasis

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