Use of SGLT2 inhibitors in cardiovascular diseases: why, when and how?

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State: Public
Version: Final published version
License: CC BY-NC-SA 4.0
Serval ID
serval:BIB_6295A67BA036
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Use of SGLT2 inhibitors in cardiovascular diseases: why, when and how?
Journal
Swiss medical weekly
Author(s)
Lu H., Meyer P., Hullin R.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
24/08/2020
Peer-reviewed
Oui
Volume
150
Pages
w20341
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of drugs that reduce blood glucose levels by increasing urinary glucose excretion. On top of the glucose-lowering effect, they offer cardiovascular and renal benefits, the mechanisms of which are probably pleiotropic and include blood pressure reduction, volume depletion, weight loss and several metabolic effects (such as lipolysis and synthesis of ketone bodies). SGLT2 inhibitors are currently indicated in Europe and the USA, as first- or second-line treatments of type 2 diabetes mellitus (T2DM) in patients with established cardiovascular disease, high/very high cardiovascular risk, renal disease or heart failure. The use of dapagliflozin has recently been extended to patients with heart failure without T2DM, as new emerging data show benefits in this population. Despite an overall favourable safety profile, attention has to be paid to the increased risk of euglycaemic diabetic ketoacidosis and genital mycotic infections, as well as lower limb amputations and fractures, which have been inconsistently associated with SGLT2 inhibition. For the moment, cost related data for the Swiss setting is lacking but corresponding analyses from abroad suggest cost-effectiveness. Despite their numerous favourable cardiorenal implications, many physicians remain hesitant to use SGLT2 inhibitors. In this article, we present an up-to-date narrative literature review of the physiological mechanisms of action, current indications, therapeutic utility and side effects of SGLT2 inhibitors.
Keywords
Cardiovascular Diseases/drug therapy, Diabetes Mellitus, Type 2/drug therapy, Heart Failure, Humans, Hypoglycemic Agents/therapeutic use, Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
19/09/2020 13:29
Last modification date
06/04/2024 7:30
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