SGLT2 inhibitors (gliflozins) antidiabetics, antihypertensives or drugs for heart failure?

Czech version

Authors: J. Špinar ¹; J. Vítovec ²; L. Špinarová ²
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno ¹; I. interní-kardioangiologická klinika LF MU a FN u sv. Anny v Brně ²
Published in: Kardiol Rev Int Med 2017, 19(3): 195-200

Overview

SGLT2 inhibitors – gliflozins were introduced into clinical practice as oral antidiabetics, acting by increased glucose excretion in urine using the blockade of the SGLT2 co-transporter, which blocks glucose reabsorption in kidneys. The first big clinical trial EMPA REG outcome has shown not only the effect on diabetes mellitus but also the effect on cardiovascular events, decreasing especially heart failure mortality and hospitalisations. A decrease in body weight by 2– 3 kg and a decrease of systolic blood pressure by 3– 5 mmHg were also new findings. The CANVAS trials were presented in 2017 and confirmed this beneficial effect, but also bring new disappointing information about increase of leg amputations. Data from real life – CVD REAL research disprove the doubts on more than 300,000 patients from all over the world and confirm the positive results from clinical trials. A large program with dapagliflozin is being conducted. A meta-analysis of 21 clinical trials confirmed the positive trend in cardiovascular events and the results of the DECLARE study are being awaited with great expectations. The DAPA HF trial started in 2017 and investigates the effect of dapagliflozin in patients with chronic heart failure with or without diabetes mellitus. The EMPEROR trials with empagliflozin in patients with both systolic and diastolic failure were also started in 2017.

Keywords:
SGLT2 – diabetes mellitus – heart failure – dapagliflozin – empagliflozin

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