SGLT2 Inhibitors Modestly Increase Hemoglobin and Hematocrit

A meta-analysis of 85 randomized clinical trials involving 70,543 participants found that sodium-glucose cotransporter 2 (SGLT2) inhibitors were associated with small but statistically significant increases in hemoglobin and hematocrit levels compared with control treatments, although the clinical significance of these changes remains unclear. The trials had a median follow-up of 24 weeks. Hemoglobin increased by 0.55 g/dL in participants receiving SGLT2 inhibitors, compared with a decrease of 0.08 g/dL in the control group, resulting in a between-group difference of 0.60 g/dL. Hematocrit increased by 2.17 percentage points in the SGLT2 inhibitor group, compared with a change of −0.13 percentage points in the control group, yielding a between-group difference of 2.36 percentage points. Among the secondary outcomes, SGLT2 inhibitor use was also associated with increased erythropoietin levels and decreased transferrin saturation. These findings suggest that SGLT2 inhibitors influence red blood cell production and iron metabolism, but further research is needed to determine the clinical implications of these changes. Source: https://jamanetwork.com/