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A recent clinical trial has shown that sodium-glucose cotransporter 2 inhibitors can lower hospitalization for heart failure and improve kidney endpoints in patients with and without type 2 diabetes mellitus.
The EMPEROR-Reduced and DAPA-CKD clinical trials support using the SGLT2 inhibitors in a wide range of populations with lesser safety concerns. Patients who benefit from SGLT2 inhibitors as part of their therapy include patients with type 2 diabetes mellitus who either have or are at risk of atherosclerotic cardiovascular disease; patients with diabetic and non-diabetic kidney disease with an eGFR>25 ml/min/1.73m2 and albuminuria levels above 200 mg/g at the commencement of therapy; and patients with heart failure and reduced left ventricular ejection fraction (<40%), irrespective of the presence of type 2 diabetes mellitus and with an eGFR >20 ml/min/1.73m2.
Secondary analyses showed renoprotection in EMPEROR-Reduced and HHF reduction in DAPA-CKD. Hence, comorbidity inherent in the cardiorenal syndrome is alleviated with the use of SGLT2 inhibitors.
Panchapakesan U, Pollock C. Organ protection beyond glycemic control with SGLT2 inhibitors. Nature Reviews. 2020; 383:1414-1424.