SGLT2 inhibitors: an evidence-based update on cardiovascular implications

Expert Opin Investig Drugs. 2023 Jul-Dec;32(9):839-847. doi: 10.1080/13543784.2023.2263354. Epub 2023 Oct 13.

Abstract

Introduction: Sodium Glucose co-Transporter 2 (SGLT2) inhibitors (also known as 'gliflozins') represent a cornerstone to treat diabetes mellitus. Moreover, recent randomized clinical trials have demonstrated important cardioprotective effects of gliflozins, independent of the presence of diabetes. Herein, we summarize the recent therapeutic progress in the cardiovascular field obtained with SGLT2 inhibitors.

Area covered: We critically examine the rationale and results of recent clinical studies examining the effects of SGLT2 inhibitors on cardiovascular outcomes, along with a brief overview of the main ongoing trials that have been designed in order to answer the many pending questions in the field of gliflozins and cardiovascular disease.

Expert opinion: The favorable results of several clinical trials have broadened the therapeutic scenario for SGLT2 inhibitors, opening, at the same time, new challenges. Additionally, recent preclinical findings have evidenced off-target effects of SGLT2 inhibitors.

Keywords: Canagliflozin; HFpEF; SGLT2i; dapagliflozin; empagliflozin; ertugliflozin; heart failure.

Publication types

  • Review

MeSH terms

  • Animals
  • Cardiovascular Diseases* / drug therapy
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypoglycemic Agents* / adverse effects
  • Hypoglycemic Agents* / pharmacology
  • Randomized Controlled Trials as Topic*
  • Sodium-Glucose Transporter 2 Inhibitors* / pharmacology

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Hypoglycemic Agents