Heart failure hospitalization with SGLT-2 inhibitors: a systematic review and meta-analysis of randomized controlled and observational studies

Expert Review of Clinical Pharmacology
Awadhesh Kumar Singh, Ritu Singh

Abstract

Heart failure (HF) in type 2 diabetes mellitus (T2DM) poses a significant increase in mortality. Until recently, anti-diabetic drugs have not been shown to reduce hospitalization due to heart failure (hHF). While thiazolidinedione class and saxagliptin has shown a significantly increased risk, sodium-glucose linked co-transporter 2 inhibitors (SGLT-2Is) have demonstrated a significant reduction in the risk of hHF. Areas covered: We systematically searched the database of PubMed, Embase, ClinicalTrials.gov, and International conference presentation up to 25 December 2018 and retrieved all the studies that were conducted for ≥24 weeks and explicitly reported hHF outcome. Subsequently, we conducted the meta-analysis to study the effect of SGLT-2Is on hHF outcome in randomized controlled trials (RCTs), observational studies, and both. Expert opinion: The meta-analysis of RCTs (N = 34,322), observational studies (N = 15,36,339), and both (N = 15,70,661) demonstrated a significant decrease in hHF (OR 0.70, 0.64, 0.66, respectively, all p = 0.000) with SGLT-2Is compared to placebo or other anti-diabetes drugs in T2DM. A significant benefit in hHF (OR 0.68, p = 0.000) is also observed in patients with established HF (N = 3891) in sub-g...Continue Reading

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Citations

Jun 25, 2019·Expert Review of Clinical Pharmacology·K Pafili, N Papanas
Dec 5, 2020·The Canadian Journal of Cardiology·Varinder Kaur RandhawaKim A Connelly
Feb 20, 2021·European Journal of Preventive Cardiology·Walter MassonGraciela Molinero
Aug 3, 2021·Frontiers in Cardiovascular Medicine·Gloria M GagerJolanta M Siller-Matula
Aug 22, 2021·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Annamaria MascoloGiuseppe Paolisso

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