Cardiovascular outcomes with sodium-glucose co-transporter 2 inhibitors a review of the clinical evidence
Many clinical trials have shown significant reductions from baseline in both systolic and diastolic blood pressure following the administration of SGLT-2 inhibitors. However, while persistently elevated blood pressure (BP) is a recognized risk factor for cardiovascular events, high BP alone does not...
| Corporate Authors: | , |
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| Format: | eBook |
| Language: | English |
| Published: |
Ottawa (ON)
Canadian Agency for Drugs and Technologies in Health
2015, 05 November 2015
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| Series: | Rapid response report: summary with critical appraisal
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| Subjects: | |
| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | Many clinical trials have shown significant reductions from baseline in both systolic and diastolic blood pressure following the administration of SGLT-2 inhibitors. However, while persistently elevated blood pressure (BP) is a recognized risk factor for cardiovascular events, high BP alone does not necessarily imply a cardiovascular event, such as myocardial infarction, stroke, heart failure, and unstable angina. A recent study has reported that empagliflozin has favorable effects on markers of arterial stiffness and vascular resistance, while another RCT concluded that compared with placebo, T2DM patients at high risk for cardiovascular events who received empagliflozin as add-on therapy to standard care had a lower rate of the primary composite cardiovascular outcome and of death from any cause. However, there is currently no conclusive outcome data on the ability of SGLT-2 inhibitors as a class to reduce the risk of cardiovascular events in patients with T2DM. The aim of this report is to review the evidence on cardiovascular outcomes with SGLT-2 inhibitors compared with placebo as well as with incretin-based therapies to help inform policy decisions Sodium-glucose co-transport 2 (SGLT-2) inhibitors are a new class of drugs used to treat type-2 diabetes (T2DM). They exert antihyperglycemic action by blocking the renal reabsorption of glucose, leading to increased urinary glucose excretion. In healthy individuals, the kidney filters up to 180g of glucose every day, which is almost entirely reabsorbed into the blood in the proximal convoluted tubule through the mediation of SGLT-1 and SGLT-2, with the latter reabsorbing the majority (80% to 90%). Based on their mechanism of action and observations from clinical trials, the SGLT-2 inhibitors have demonstrated the potential to reduce the risk of cardiovascular events in addition to reducing blood glucose levels. By inhibiting renal reabsorption of glucose, they lower blood glucose to clinically significant levels, increase the potential for weight loss through calorie reduction, and increase water content of urine by osmotic diuresis to potentially reduce blood pressure. |
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| Physical Description: | 1 PDF file (24 pages) |