Sodium-Glucose Cotransporter-2 Inhibition Benefits in Cardiorenal Risk in Men and Women
Open Access
- 13 December 2022
- journal article
- research article
- Published by The Endocrine Society in Journal of the Endocrine Society
- Vol. 7 (2), bvac191
- https://doi.org/10.1210/jendso/bvac191
Abstract
Introduction In addition to their antihyperglycemic action, sodium-glucose cotransporter-2 (SGLT2) inhibitors are used in patients with Type 2 Diabetes due to their cardioprotective effects. Meta-analyses of large clinical trials have reported mixed results when examining sex differences in their cardioprotective effects. For example, some studies reported that, compared to women, men had a greater reduction in cardiovascular risk with SGLT2 inhibition. Taking advantage of several recently-completed large-scale randomized controlled clinical trials, we tested the hypothesis that women have an attenuated response in primary cardiorenal outcomes to SGLT2 inhibition compared to men. Methods We performed a systematic search using PubMed and the Cochrane Library to find completed large-scale, prospective, randomized-controlled Phase III clinical trials with primary outcomes testing cardiovascular or renal benefit. Studies had to include at least 1,000 participants and report data about sex differences in their primary cardiovascular or renal outcomes. Results The present meta-analysis confirmed that SGLT2 inhibition decreased adverse cardiorenal outcomes in a pooled sex analysis using 13 large-scale clinical trials. SGLT2 inhibition exhibited similar reduction in hazard ratios for both men (0.79, 95% confidence interval 0.73-0.85) and women (0.78, 95% confidence interval 0.72-0.84) for adverse cardiorenal outcomes. Conclusion In contrast to previous findings, our updated meta-analysis suggests that women and men experience similar cardiorenal benefit in response to SGLT2 inhibition. These findings strongly suggest that SGLT2 inhibition therapy should be considered in patients with high risk for cardiovascular disease irrespective of the patient sex.Funding Information
- National Institutes of Health National Institute of General Medical Sciences (P20GM121334)
- National Institute on Minority Health and Health Disparities (P50MD017338)
- National Institute of Diabetes and Digestive and Kidney Diseases (R21DK113500)
- National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases (F30DK127527)
- National Institutes of Health
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