Sodium/glucose cotransporter 2 inhibitors in chronic kidney disease and heart failure: ready for prime time in patients without diabetes

Vlasschaert, Caitlyn; Sidhu, Bikrampal; Silver, Samuel A.

doi:10.1097/mnh.0000000000000703

Cited by 3 publications

(1 citation statement)

References 49 publications

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“…17,19 The cost of non-PBS subsidised drugs would have had implications for people with T2D and limited financial resources. It is likely that use of SGLT2is in T2D will increase significantly in the future, especially as they have been shown to have cardiorenal benefits and thus potential application beyond T2D, 21 which should increase prescriber awareness.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular disease management in Australian adults with type 2 diabetes: insights from the CAPTURE study

Davis

Colman

Hespe

et al. 2022

Internal Medicine Journal

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BackgroundType 2 diabetes (T2D) is a well‐recognised cardiovascular disease (CVD) risk factor, and recent guidelines for the management of T2D include consideration of CVD risk.AimTo assess whether contemporary clinical management of Australians with T2D is in accord with recent national and international guidelines.MethodsThis Australia‐specific analysis of the CAPTURE study, a non‐interventional, cross‐sectional study included adults diagnosed with T2D ≥180 days prior to providing informed consent and visiting primary or specialist care. Main outcome measures were the use of blood glucose‐lowering medications (BGLMs), BGLMs with proven cardiovascular benefits and other CVD medications, stratified by CVD status and care setting.ResultsOf 824 Australian participants in the CAPTURE sample, 332 (40.3%) had CVD. Oral BGLMs were used by 83.9% of all participants, most commonly metformin (76.0%), dipeptidyl peptidase‐4 inhibitors (28.8%), sodium‐glucose cotransporter‐2 inhibitors (SGLT2is; 21.8%) and sulfonylureas (21.7%). Insulin was used by 29.2% of participants. BGLMs with proven CV benefit were used by 22.6%; glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) were less commonly used than SGLT2is in all CVD groups, but these drug classes were more often prescribed in specialist than primary care (SGLT2is 25.4 vs 20.7%, GLP‐1 RAs 3.2 vs 0.8% respectively). Use of non‐BGLMs for CVD risk reduction appeared consistent with guidelines.ConclusionsUse of BGLMs with CVD benefits appears low in Australia, irrespective of CVD status. This likely reflects the delay in translation of clinical evidence into contemporary care and prescribing restrictions.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular disease management in Australian adults with type 2 diabetes: insights from the CAPTURE study

Davis

Colman

Hespe

et al. 2022

Internal Medicine Journal

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The efficacy and safety of SGLT2 inhibitors in patients with non-diabetic chronic kidney disease: a systematic review and meta-analysis

et al. 2023

Int Urol Nephrol

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Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Cardiac Structural and Electrical Remodeling: From Myocardial Cytology to Cardiodiabetology

Marketou

Kontaraki

Maragkoudakis

et al. 2022

CVP

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Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have changed the clinical landscape of diabetes mellitus (DM) therapy through their favourable effects on cardiovascular outcomes. Notably, the use of SGLT2i has been linked to cardiovascular benefits regardless of DM status, while their pleiotropic actions remain to be fully elucidated. What we do know is that SGLT2i exert beneficial effects even at the level of the myocardial cell, and that these are linked to an improvement in the energy substrate, resulting in less inflammation and fibrosis. SGLT2i ameliorate myocardial extracellular matrix remodeling, cardiomyocyte stiffness and concentric hypertrophy, achieving beneficial remodeling of the left ventricle with significant implications for the pathogenesis and outcome of heart failure. Most studies show a significant improvement in markers of diastolic dysfunction along with a reduction in left ventricular hypertrophy. In addition to these effects there is electrophysiological remodeling, which explains initial data suggesting that SGLT2i have an antiarrhythmic action against both atrial and ventricular arrhythmias. However, future studies need to clarify not only the exact mechanisms of this beneficial functional, structural, and electrophysiological cardiac remodeling, but also its magnitude, and to determine whether this is a class or a drug effect.

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Sodium/glucose cotransporter 2 inhibitors in chronic kidney disease and heart failure: ready for prime time in patients without diabetes

Cited by 3 publications

References 49 publications

Cardiovascular disease management in Australian adults with type 2 diabetes: insights from the CAPTURE study

Cardiovascular disease management in Australian adults with type 2 diabetes: insights from the CAPTURE study

The efficacy and safety of SGLT2 inhibitors in patients with non-diabetic chronic kidney disease: a systematic review and meta-analysis

Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Cardiac Structural and Electrical Remodeling: From Myocardial Cytology to Cardiodiabetology

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