Current drug safety最新文献

{"title":"Drug-Induced Acute Kidney Injury: Mechanisms, Biomarkers, and Therapeutic Strategies.","authors":"Baban Thawkar, Fariah Rizwani, Khush Jain","doi":"10.2174/0115748863362596250627155607","DOIUrl":"https://doi.org/10.2174/0115748863362596250627155607","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a severe and life-threatening complication of drug therapy, a significant risk to patient well-being, with high morbidity and death rates. An increasing proportion of AKI cases are mainly caused due to drug-induced nephrotoxicity; despite its prevalence, the exact study of causative drugs is still unclear. AKI is often caused by kidney damage, reducing the kidneys' ability to detoxify, eventually leading to nephrotoxicity. Drug-induced nephrotoxicity often happens through various mechanisms such as crystal nephropathy, oxidative stress, reduced flow to the kidneys, damage to kidney cells, and thrombotic microangiopathy. Epidemiology of drug-induced nephrotoxicity focuses on how prevalent it is and the factors that increase the nephrotoxicity. Specific biomarkers have been found to assess nephrotoxicity for early and accurate diagnosis of kidney damage. This review focuses on explaining drug-induced nephrotoxicity mechanisms for commonly used agents such as non-steroidal anti-inflammatory drugs, immunosuppressants, antibiotics, anticancer agents, and antifungals. It also covers specific biomarkers and respective treatment approaches. Additionally, protective agents and their mechanisms in preventing nephrotoxicity are also analyzed, including their antioxidant and anti-inflammatory potential and other drug-based interventions. This review discusses various therapeutic studies using experimental models, offering invaluable insights into the cellular processes and pathways involved in developing prevention strategies. By advancing our understanding of the mechanisms behind drug-induced nephrotoxicity, it is aimed to improve patient care and reduce health-related complications.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial Dysfunction in Neurodegenerative Disorders: Role of Prototype Targeted Drug Delivery Solutions.","authors":"Dilpreet Singh","doi":"10.2174/0115748863375490250626163609","DOIUrl":"https://doi.org/10.2174/0115748863375490250626163609","url":null,"abstract":"<p><p>Mitochondrial dysfunction plays a central role in the pathogenesis of neurodegenerative disorders, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and Amyotrophic Lateral Sclerosis (ALS). Targeted drug delivery to mitochondria represents a promising therapeutic strategy to mitigate neuronal degeneration and preserve mitochondrial function in these devastating conditions. This review provides a comprehensive overview of recent advances in targeted drug delivery solutions for mitochondrial dysfunction in neurodegenerative disorders. The mechanisms underlying mitochondrial dysfunction in AD, PD, HD, and ALS are explored, highlighting the specific challenges and opportunities for therapeutic intervention. Emerging drug delivery technologies are discussed, including mitochondriaresponsive systems, nanoparticles, peptides, and viral vectors, designed to deliver therapeutic agents directly to mitochondria along with suitable case studies. Furthermore, preclinical and clinical studies evaluating the efficacy and safety of mitochondria-targeted therapeutics are reviewed, and future directions and challenges in the field are outlined. By elucidating the intersection of mitochondrial biology and drug delivery, this review aims to inspire further research and innovation toward effective treatments for neurodegenerative diseases.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Adverse Drug Reaction to Thalidomide: A Case Report.","authors":"Akshay Sankar Peethambaran, Neel Prabha, Prateek Pujar","doi":"10.2174/0115748863378453250623061903","DOIUrl":"https://doi.org/10.2174/0115748863378453250623061903","url":null,"abstract":"<p><strong>Background: </strong>Thalidomide has emerged as a novel antitumor drug with antiangiogenic and immunomodulatory properties. It was taken off the market in the early 1960s due to its infamous connection with congenital defects. Recently, the FDA approved thalidomide for treating erythema nodosum leprosum, adhering to strict guidelines and safety measures. Sensory peripheral neuropathy and teratogenicity, fatigue, vertigo, headache, gastrointestinal issues, skin eruptions, dizziness, galactorrhoea, decreased libido, and constitutional symptoms like fever, weakness, headaches, and weight loss are the main adverse effects of thalidomide.</p><p><strong>Case report: </strong>We report a case of a 46-year-old female diagnosed with lepromatous leprosy on multibacillary multidrug therapy presenting with unusual adverse reactions, such as generalized burning sensation, breathlessness, and low backache after the intake of thalidomide.</p><p><strong>Conclusion: </strong>We describe an unusual adverse reaction to thalidomide that has not previously been reported in the literature and aim to alert clinicians about the unusual, adverse reaction as an uncommon side effect of thalidomide and to always keep in mind if the patient develops any of these symptoms.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Impact of Antibodies Against TNF Alpha Inhibitors in Rheumatoid Arthritis and Spondyloarthritis: Systematic Review and Meta- Analysis with Subgroup Analysis.","authors":"Ines Mahmoud, Selma Bouden, Rim Charfi, Yosr Abid, Chedly Dziri, Mouna Ben Sassi, Leila Rouached, Aicha Ben Tekaya, Raoudha Tekaya, Olfa Saidane, Leila Abdelmoula","doi":"10.2174/0115748863354926250620200719","DOIUrl":"https://doi.org/10.2174/0115748863354926250620200719","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to estimate the global prevalence of anti-drug antibodies (ADAb), their impact on response, and associated factors in adults with rheumatoid arthritis (RA) and spondyloarthritis (SpA) treated by TNF alpha inhibitors (TNF-i).</p><p><strong>Methods: </strong>We searched PubMed, MEDLINE, Cochrane, Web of Science, and Scopus for observational, population-based studies published between Jan 2010 and Sept 2021. We included studies that reported the prevalence of ADAb (our main outcome) and examined their impact on treatment efficacy in adults treated with TNF-i (secondary outcome). To investigate heterogeneity, we used a Q-test and predictive interval.</p><p><strong>Results: </strong>The overall global prevalence of ADAb in RA was 20.8% (95%CI,6.8-25.5) (95%PI,6.12-51.42) and in SpA 24.8% (95%CI,19.1-31.5) (95%PI,7.31-57.98). There was no significant difference in the prevalence of ADAb between infliximab (IFX) and adalimumab (ADA) in RA (p=0.21) nor in SpA (p=0.46). There was a statistically significant difference between IFX and etanercept (ETN) in RA (p<0.0001) as well as in SpA (p=0.001) and, likewise, between ADA and ETN in RA (p<0.0001) and in SpA (p=0.002). Study by subgroups of the impact of immunogenicity on response, according to the type of TNF-i, showed that the mean OR for ADA was 0.152 (CI 95%, 0.054 to 0.427) and for IFX was 0.144 (CI 95%, 0.055 to 0.378). The pairwise comparison of ADA vs IFX was not statistically significant (p=0.94). In subgroup analysis, according to the disease, the mean OR for RA was 0.149 (IC 95% 0.064 to 0.347) and for SpA was 0.303 (IC95% 0.103 to 0.890). The pairwise comparison of RA vs SpA was not statistically significant. The use of methotrexate tends to reduce the development of ADAb in RA and SpA with an OR=0.472 (CI95%,0.324-0.689) (PI95%,0.16-1.39).</p><p><strong>Conclusion: </strong>ADAb were equally prevalent in RA and SpA treated with TNF-i. Immunogenicity was associated with response to treatment and influenced by concomitant use of methotrexate.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Pharmacovigilance in Pharmaceutical Companies: A Comparative Study of Electronic Reporting Before and After Implementation.","authors":"Ghita Meknassi Salime, Nihal Bhirich, Abdelghani Asraoui, Moulay El Hassan El Karimi, Younes Rahali, Houda Sefiani","doi":"10.2174/0115748863339571250610103928","DOIUrl":"https://doi.org/10.2174/0115748863339571250610103928","url":null,"abstract":"<p><strong>Background: </strong>Since 2016, Moroccan pharmaceutical companies have been required to report adverse effects linked to their medicines. Initially, reports were submitted using the CIOMS form, sent by normal mail to le Centre Antipoison et de Pharmacovigilance du Maroc, then using XML files in ICH E2B format, sent electronically. In 2021, a \"vigiflow e-reporting for industry\" standardized online reporting system was implemented. The primary objective of this study was to evaluate the pharmaceutical companies' use of electronic reporting. Secondarily, the study aimed to assess the quality of adverse drug reaction reports by comparing completeness scores across the three reporting means.</p><p><strong>Methods: </strong>All individual case safety reports sent by pharmaceutical companies from January 1, 2019, to December 31, 2023, were extracted from Vigibase®. A quantitative and qualitative analysis was conducted, and a statistical comparison of data was performed using p-values. VigiGrade completeness score was calculated for a sample size selected.</p><p><strong>Results: </strong>The highest number of reports were from E-reporting (50%), followed by CIOMS (29%) and E2B (21%). Between 2019 and 2021, CIOMS and E2B notifications decreased along with reporting laboratories. However, after 2021, electronic reporting increased steadily alongside reporting companies. Comparing vigiGrade completeness score across reporting means revealed no statistically significant differences (p = 0.094 > 0.05).</p><p><strong>Conclusion: </strong>Electronic reporting shows quantitative effectiveness and consistent quality. Its adoption remains limited and requires continuous strengthening, particularly through increased awareness among pharmaceutical companies.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Vericiguat in Heart Failure: Mechanistic Insights, Therapeutic Advantages, and Clinical Validation.","authors":"Wen-Rui Hao, Chun-Han Cheng, Huan-Yuan Chen, Ju-Chi Liu, Tzu-Hurng Cheng, Jin-Jer Chen","doi":"10.2174/0115748863377494250530105725","DOIUrl":"https://doi.org/10.2174/0115748863377494250530105725","url":null,"abstract":"<p><p>Vericiguat, a novel stimulator of soluble guanylate cyclase (sGC), marks a significant advancement in the management of heart failure with reduced ejection fraction (HFrEF). By enhancing the nitric oxide signaling pathway, it facilitates vasodilation and improves myocardial function. Clinical trials, including the VICTORIA study, have demonstrated that vericiguat effectively reduces the risk of cardiovascular death and hospitalizations associated with chronic HFrEF. The favorable safety profile of this drug, with tolerability comparable to placebo, further supports its suitability for long-term use. Understanding the pharmacodynamics and pharmacokinetics of vericiguat is essential to appreciating its clinical efficacy and its role in current heart failure treatment strategies. This review explores existing research to explore the therapeutic potential of vericiguat, its practical implications for patient care, and the need for further investigation to expand its applications. By addressing unmet needs in heart failure management, vericiguat represents a promising addition to contemporary treatment paradigms.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Drug Reaction Profile of Capecitabine-based Chemotherapy Regimen and its Predisposing Factors in Patients Attending a Tertiary Care Hospital in South India.","authors":"Avishek Amar, Jayanthi Mathaiyan, Biswajit Dubashi","doi":"10.2174/0115748863366875250526114841","DOIUrl":"https://doi.org/10.2174/0115748863366875250526114841","url":null,"abstract":"<p><strong>Background: </strong>Capecitabine, an important drug used for solid tumors involving the gastrointestinal tract, is known to be associated with many Adverse Drug Reactions (ADRs) leading to dose modification or discontinuation.</p><p><strong>Objective: </strong>The objective of this study was to determine the frequency and pattern of adverse drug reactions (ADRs) associated with capecitabine-based chemotherapy regimens (CBCR).</p><p><strong>Methods: </strong>A prospective observational study was carried out at a regional cancer center in South India. A total of 120 cancer patients receiving CBCR were recruited and interviewed for the occurrence of any ADRs during the complete course of chemotherapy cycles. The adverse drug events were graded for severity as per the CTCAE criteria (v4.03), and causality assessment was done using the WHO and Naranjo scales. The preventability assessment of the ADRs was conducted using the modified Schumock and Thornton scale. The chi-squared test was used to analyze the difference in the frequency of ADRs among cancer types, genders, and chemotherapy regimens.</p><p><strong>Results: </strong>The majority of ADRs (96.6%) reported throughout the treatment cycles were from the gastrointestinal system, followed by neurology-related events (93.3%). Among the various ADRs detected, skin/nail discoloration and fatigue/weakness were the most frequently reported. Causality analysis classified most ADRs under the \"possible\" category (50.5% by the WHO scale and 50.9% by the Naranjo scale). Most ADRs were of Grade I severity (54.5%) and were deemed \"probably preventable.\"</p><p><strong>Conclusion: </strong>CBCR was associated with several ADRs, though most were of Grade I severity and primarily affected the gastrointestinal system. The majority of ADRs were classified as \"possible\" based on causality analysis, and most were deemed \"probably preventable.\" Future research could focus on ameliorating these ADRs to avoid dose adjustments or discontinuation of chemotherapy.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Non-Steroidal Anti-Inflammatory Drugs on Gastrointestinal Bleeding: Review on Risk Scoring for Better Prediction.","authors":"Dwi Aris Agung Nugrahaningsih, - Mustofa, Woro Rukmi Pratiwi, Dyah Samti Mayasari, Shaula Chintyasari","doi":"10.2174/0115748863356598250523095124","DOIUrl":"https://doi.org/10.2174/0115748863356598250523095124","url":null,"abstract":"<p><p>Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain relief and inflammation management; however, they can lead to serious upper gastrointestinal (GI) issues, including ulcers, bleeding, and perforations. This review explores various risk factors for NSAID-related GI complications, including medication dosage, duration of treatment, patient age, health history, and interactions with other drugs. It also evaluates existing measures to reduce these risks, such as using proton pump inhibitors (PPIs) and selective COX-2 inhibitors, while discussing their limitations. Emphasis is placed on the value of prediction tools that integrate multiple risk factors to enhance preventive care. The review provides an in-depth analysis of current scoring systems and examines future directions, including the integration of biomarkers, genetic data, and technologies like machine learning to improve prediction and clinical utility. By addressing gaps in existing models, it offers insights into advancing personalized approaches to minimize NSAID-induced GI complications.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DRESS Syndrome with Cold Agglutinins: An Unusual Immune Response to Anticonvulsants.","authors":"Sumit Jaiswal, Sourabh Pathania, Gaurav Sharma, Ankur Singh, Upinder Kaur, Anup Singh, Sankha Shubhra Chakrabarti","doi":"10.2174/0115748863384587250519045051","DOIUrl":"https://doi.org/10.2174/0115748863384587250519045051","url":null,"abstract":"<p><strong>Introduction: </strong>DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) is a rare adverse drug reaction characterized by cutaneous and systemic manifestations, with a mortality rate of up to 10%. In this study, we describe the case of a 77-year-old man who developed DRESS syndrome with cold agglutination.</p><p><strong>Case presentation: </strong>A 77-year-old man prescribed phenytoin and carbamazepine for suspected cranial neuralgia after a tooth extraction developed high-grade fever and hemorrhagic crusting on the upper and lower lips and oral mucosa, morbilliform rashes over the chest, abdomen, and back along with facial edema, all occurring over 2 weeks. Clinically significant right-sided submandibular, cervical, and axillary lymphadenopathy was observed. Additional findings, including peripheral blood eosinophilia, hepatitis, and coagulopathy, helped us make a provisional diagnosis of DRESS syndrome. The peripheral blood smear showed an incidental finding of cold agglutination phenomenon at room temperature (16 °C; winter months in North India), which disappeared under warmer conditions. However, gross hemolysis was not confirmed. The patient showed significant response in both clinical and hematological parameters within 24 hours of initiating intravenous dexamethasone, which was continued and gradually tapered over 14 days. Follow-up at one month showed the disappearance of the cold agglutination phenomenon.</p><p><strong>Conclusion: </strong>Cold agglutination in DRESS syndrome has not been documented in detail in the past. One hypothesis is the agglutination of red blood cells (RBCs) due to the effect of the pathogenetic antibodies in DRESS syndrome directed against RBC antigens. Further molecular research may elucidate the pathways of this rare clinical finding.</p>","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of SGLT-2 Inhibitors on Frailty in Older Adults: A Clinical Review.","authors":"Sulthan Al Rashid, Abinaya Vannapatti Gopalakrishnan, Naina Mohamed Pakkir Maideen, Riyadh S Almalki","doi":"10.2174/0115748863365749250519051710","DOIUrl":"https://doi.org/10.2174/0115748863365749250519051710","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, including empagliflozin, canagliflozin, and dapagliflozin, have demonstrated significant cardiovascular and renal benefits in managing type 2 diabetes mellitus (T2DM). However, their impact on frailty in older adults remains a subject of debate, given their associations with weight loss, fluid depletion, and potential reductions in muscle mass, which could contribute to sarcopenia and frailty-related complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This narrative review evaluates the effects of SGLT-2 inhibitors on frailty in older adults with T2DM by analyzing their influence on body composition, muscle mass, and overall functional status. It further examines the balance between their benefits and risks in frail populations, emphasizing the need for appropriate patient selection and monitoring strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive review of systematic reviews, meta-analyses, randomized controlled trials (RCTs), and real-world observational studies was conducted. Data were obtained from major medical databases, including PubMed, Embase, Cochrane Library, and Web of Science. Studies focusing on body composition changes, cardiovascular outcomes, frailty-related events, and mortality in older adults using SGLT-2 inhibitors were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings indicate that SGLT-2 inhibitors significantly reduce body weight, visceral fat, and cardiovascular events while preserving renal function. However, multiple studies report reductions in lean body mass and skeletal muscle index, raising concerns about sarcopenia, particularly in frail individuals. Meta-analyses of RCTs reveal that SGLT-2 inhibitors may decrease skeletal muscle mass while promoting lipolysis and gluconeogenesis, potentially exacerbating frailty in high-risk populations. Despite these concerns, retrospective cohort studies and real-world evidence suggest that SGLT-2 inhibitors are associated with lower mortality and reduced frailty-related events in individuals with T2DM and heart failure. Comparative studies highlight that SGLT-2 inhibitors provide superior cardiovascular protection over dipeptidyl peptidase-4 inhibitors (DPP- 4is) and comparable benefits to glucagon-like peptide-1 receptor agonists (GLP-1RAs), albeit with an increased risk of DKA and genital infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While SGLT-2 inhibitors offer significant cardiometabolic and renal benefits, their effects on muscle mass and frailty warrant further investigation. Individualized treatment approaches- including nutritional support, exercise interventions, and close monitoring-are essential to mitigate potential risks in frail older adults. Updated clinical guidelines should address the appropriate use of SGLT-2 inhibitors in frail populations, considering both their benefits and risks. Future research should focus on elucidating the biological mechanisms underlying the","PeriodicalId":10777,"journal":{"name":"Current drug safety","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}