Prevention of Cardiorenal Complications with Sodium-Glucose Cotransporter Type 2 Inhibitors: A Narrative Review.

IF 2.8 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes Therapy Pub Date : 2022-07-01 Epub Date: 2022-06-15 DOI:10.1007/s13300-022-01277-1

Manuel Botana, Javier Escalada, Ángel Merchante, Rebeca Reyes, Pedro Rozas

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Abstract

Heart failure (HF) and chronic kidney disease (CKD) are the most frequent first cardiorenal conditions in patients with type 2 diabetes (T2D), which can be exacerbated by other comorbidities, such as hypertension, dyslipidemia, and obesity. To improve their clinical outcomes, patients with T2D need to achieve and maintain glycemic targets, as well as prevent cardiorenal disease onset and progression. Several clinical trials evaluating the sodium-glucose cotransporter type 2 inhibitors (SGLT2i) dapagliflozin, empagliflozin, canagliflozin, and ertugliflozin have shown consistent risk reduction in major adverse cardiovascular events and/or hospitalization for HF, together with lower risk of kidney disease progression. The benefits associated with SGLT2i in T2D are distinct from other antihyperglycemic drugs since they have been proposed to exert pleiotropic metabolic and direct effects on the kidney and the heart. In this review, we summarize and discuss the evidence regarding the mechanisms of action, the efficacy and safety profiles, and the clinical guidelines on the use of the therapeutic class of SGLT2i, highlighting their role in cardiorenal prevention beyond glycemic control.

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钠-葡萄糖共转运蛋白2型抑制剂预防心肾并发症的研究综述

心力衰竭（HF）和慢性肾脏病（CKD）是 2 型糖尿病（T2D）患者最常见的首发心肾疾病，而高血压、血脂异常和肥胖等其他并发症又会加重病情。为了改善临床疗效，2 型糖尿病患者需要达到并维持血糖目标，同时预防心肾疾病的发生和发展。评估钠-葡萄糖共转运体 2 型抑制剂（SGLT2i）达帕利氟嗪（dapagliflozin）、恩帕利氟嗪（empagliflozin）、卡那利氟嗪（canagliflozin）和厄吐利氟嗪（ertugliflozin）的几项临床试验显示，主要不良心血管事件和/或因高血压住院的风险持续降低，肾病恶化的风险也有所降低。SGLT2i对T2D的益处不同于其他降糖药物，因为它们被认为对肾脏和心脏具有多向代谢和直接作用。在这篇综述中，我们总结并讨论了有关 SGLT2i 类药物的作用机制、疗效和安全性的证据，以及使用这类治疗药物的临床指南，强调了它们在血糖控制之外的心肾功能预防方面的作用。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

自引率

7.90%

发文量

130

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.