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SGLT2 inhibitors reduce heart-failure-–related hospitalization in patients without diabetes
Clinical Question
Is treatment with sodium glucose co-transporter 2 inhibitors effective in decreasing hospitalization for patients with heart failure, with or without diabetes?
Bottom line
In patients with heart failure but without diabetes, adding an SGLT2 inhibitor to treatment will have a modest effect on decreasing the likelihood of hospitalization for heart failure. Unlike a previous meta-analysis with fewer studies overall mortality risk was not reduced, though cardiovascular mortality was slightly lessened. Several guideline-development groups have added SGLT2 inhibitors to their algorithms for treatment. 1a
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Foundation
Setting: Various (meta-analysis)
Synopsis
These researchers followed PRISMA guidelines for conducting and reporting this analysis. They searched 4 databases, including the Cochrane Library, as well as reference lists and other systematic reviews, and they polled experts. They identified 8 randomized controlled trials, published in English, enrolling a total of 15,022 patients with heart failure who were followed up for at least 6 months. Most of the trials were at low risk of bias and heterogeneity among study results was very low. Sodium glucose co-transporter 2 (SGLT2) inhibitor treatment, added to existing therapy, reduces the risk for hospitalization over the first 6 months by approximately one-third (41 to 78 fewer hospitalizations per 1000 people treated). All-cause mortality was not affected by treatment, but cardiovascular mortality was decreased with treatment (2 to 41 fewer deaths per 1000 treated patients over 1 year). There was no difference in outcomes with or without diabetes or with preserved or reduced ejection fraction. The effect of treatment was greater in the first year and in patients with a poorer prognosis. This analysis did not attempt to differentiate effectiveness among the various options.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Good new data on a drug actually helpful in heart failure
Good review
Effet des inhibiteurs du SGLT2
Cela va dans le sens de ce que les différents représentant nous donne mais au moins cela semble un effet de classe plutôt que d’une marque
Beneficial effects of SGLT2 INHIBITORS in cardiac illness in
SGLT2 Inhibitors are effective in reducing the incidence of hospitalization due to cardiac morbidity in non diabetics