Combined SGLT1/SGLT2 inhibitor shows significant cardiovascular benefits in patients with CV conditions and type 2 diabetes
Sotagliflozin is known to produce large benefits in patients with reduced ejection fraction and preserved ejection fraction. Its effectiveness in HFpEF (heart failure with preserved ejection fraction) treatment is less known. Results from two studies namely, the Effect of Sotagliflozin on Cardiovascular Events in Patients With Type 2 Diabetes Post Worsening Heart Failure (SOLOIST-WHF) and the Effect of Sotagliflozin on Cardiovascular and Renal Events in Patients With Type 2 Diabetes and Moderate Renal Impairment Who Are at Cardiovascular Risk (SCORED) trials were published in the New England Journal of Medicine under the title “Combined SGLT1/SGLT2 inhibitor shows significant cardiovascular benefits in patients with CV conditions and type 2 diabetes”. The summary of this article is given below:
Objective:
To update on the effect of sotagliflozin on HFpEF.
Method:
This meta-analysis assessed a total of 11,784 participants. Patients hospitalized for heart failure about to be discharged, or who had been discharged within the last three days have been enrolled in SOLOIST-WHF. SCORED enrolled patients with chronic kidney disease and an estimated glomerular filtration rate (eGFR) between 25 and 59 age who also had type 2 diabetes and CV risk factors. for total cardiovascular death, hospitalization for HF, and urgent HF visit for the effect of sotagliflozin over placebo. The main outcome was the time to the first occurrence of cardiovascular death or hospitalized heart failure. Both the trials were terminated early due to funding difficulties exacerbated by the COVID-19 pandemic.
Findings:
The HF benefit was significant across the range of reduced to preserved ejection fraction (EF). Additionally, cardiovascular death was reduced along with heart failure improvement and renal protection, but this doesn’t reach statistical significance due to early termination. Early eGFR changes were observed with benefit in acute kidney injury.
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