Skip to main content
SpringerLink
Log in

SGLT2 INHIBITORS IN 2020

SGLT2 inhibitors may offer benefit beyond diabetes

  • Year in Review
  • Published:

From Nature Reviews Nephrology

View current issue Sign up to alerts

Sodium–glucose co-transporter 2 inhibitors offer impressive cardiac and kidney outcome benefits to people with type 2 diabetes mellitus (T2DM). These benefits now appear to extend to people without T2DM, according to three trials published in 2020.

Key advances

  • Empagliflozin and dapagliflozin improved heart failure outcomes and reduced the decline in estimated glomerular filtration rate for people with heart failure and reduced ejection fraction in large outcome trials; half of the participants did not have type 2 diabetes mellitus (T2DM) at treatment initiation.

  • Dapagliflozin improved kidney and cardiac outcomes for people with chronic kidney disease with substantial albuminuria in a large outcome trial in which one third of people did not have T2DM at treatment initiation.

  • No evidence suggests that the benefits observed within the trials differs between people with or without T2DM at treatment initiation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1: Benefits of SGLT2 inhibitors to kidney and heart failure outcomes in people with and without diabetes.

References

  1. McMurray, J. J. V. et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N. Engl. J. Med. 381, 1995–2008 (2019).

    Article  CAS  Google Scholar 

  2. Petrie, M. C. et al. Effect of dapagliflozin on worsening heart failure and cardiovascular death in patients with heart failure with and without diabetes. JAMA 323, 1353–1368 (2020).

    Article  CAS  Google Scholar 

  3. Jhund, P. S. et al. Efficacy of dapagliflozin on renal function and outcomes in patients with heart failure with reduced ejection fraction: results of DAPA-HF. Circulation https://doi.org/10.1161/CIRCULATIONAHA.120.050391 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Perkovic, V. et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N. Engl. J. Med. 380, 2295–2306 (2019).

    Article  CAS  Google Scholar 

  5. Packer, M. et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N. Engl. J. Med. 383, 1413–1424 (2020).

    Article  CAS  Google Scholar 

  6. Anker, S. D. et al. Effect of empagliflozin on cardiovascular and renal outcomes in patients with heart failure by baseline diabetes status - results from the EMPEROR-reduced trial. Circulation (2020).

  7. Heerspink, H. J. L. et al. Dapagliflozin in patients with chronic kidney disease. N. Engl. J. Med. 383, 1436–1446 (2020).

    Article  CAS  Google Scholar 

  8. Wheeler, D. C. et al. The dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) trial: baseline characteristics. Nephrol. Dial. Transplant. 35, 1700–1711 (2020).

    Article  Google Scholar 

  9. Lytvyn, Y. et al. Sodium glucose cotransporter-2 inhibition in heart failure. Circulation 136, 1643–1658 (2017).

    Article  CAS  Google Scholar 

  10. Packer, M. Activation and inhibition of sodium-hydrogen exchanger is a mechanism that links the pathophysiology and treatment of diabetes mellitus with that of heart failure. Circulation 136, 1548–1559 (2017).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Renal and Metabolic Division, The George Institute for Global Health, UNSW Sydney, Sydney, Australia

    Amy Kang & Meg J. Jardine

  2. Prince of Wales Hospital, Sydney, Australia

    Amy Kang

  3. NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia

    Meg J. Jardine

  4. Concord Repatriation General Hospital, Sydney, Australia

    Meg J. Jardine

Authors
  1. Amy Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meg J. Jardine
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Meg J. Jardine.

Ethics declarations

Competing interests

A.K. is supported by an NHMRC Postgraduate Scholarship. M.J. is supported by a Medical Research Future Fund Next Generation Clinical Researchers Program Career Development Fellowship; is responsible for research projects that have received unrestricted funding from Gambro, Baxter, CSL, Amgen, Eli Lilly and MSD; has served on advisory boards sponsored by Akebia, Astra Zeneca, Baxter, Bayer, Boehringer Ingelheim, MSD and Vifor; serves on Steering Committee for trials sponsored by Janssen and CSL; has spoken at scientific meetings sponsored by Janssen, Amgen, Roche and Vifor; with any consultancy, honoraria or travel support paid to her institution.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kang, A., Jardine, M.J. SGLT2 inhibitors may offer benefit beyond diabetes. Nat Rev Nephrol 17, 83–84 (2021). https://doi.org/10.1038/s41581-020-00391-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41581-020-00391-2

  • Springer Nature Limited

This article is cited by

Search

Navigation