SGLT2 Inhibitor’s Heart Benefit Extended

A systematic review and meta-analysis concluded that sodium–glucose cotransporter-2 (SGLT2) inhibitors reduced hospitalizations for heart failure (HF) regardless of the presence of diabetes. The analysis included trials that randomly assigned adults with HF to SGLT2 inhibitors or control. Time-to-event individual patient data were reconstructed from published Kaplan–Meier plots; time-varying risk ratios (RRs) were calculated in half-, 1-, and 2-year time frames; and anticipated absolute benefits were calculated using simple models applying relative effects to baseline risks. SGLT2 inhibitors reduced HF hospitalization by 37%, 32%, and 26% at 6 months, 1 year, and 2 years (all high certainty), respectively, and reduced cardiovascular death by 14% at 1 year (high certainty). Nevertheless, low-certainty evidence did not indicate protection against all-cause death, kidney disease progression, or kidney failure. Anticipated absolute benefits were greater for patients treated in the first year and for those with poorer prognoses, such as those newly diagnosed with HF in the hospital. However, SGLT2 inhibitors increased the risk for genital infections (RR, 2.69; high certainty). Source: https://www.acpjournals.org/