A new class of therapies called sodium-glucose cotransporter 2 inhibitors (SGLT2is) improves long-term outcomes among patients with transthyretin amyloid cardiomyopathy (ATTR-CM), according to a review recently published in the European Journal of Clinical Investigation.
SGLT2is have a clinical effect on the heart, kidneys, and metabolism, the study said.
What is ATTR-CM?
Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is a rare progressive disease of the heart muscle that leads to congestive heart failure. It occurs when the transthyretin protein produced by the liver is unstable. Symptoms include fatigue; shortness of breath; irregular heart rate or palpitations; swelling of the legs, ankles and stomach; brain fog; wheezing; and dizziness. It often goes underdiagnosed because of a lack of awareness and knowledge of the disease. There is currently no cure for ATTR-CM.
“The use of SGLT2is may be associated with a more favourable prognosis in patients with ATTR-CM,” study authors said. “Further research, particularly adequately powered, long-term [randomized controlled trials], is required to validate and strengthen the existing observational evidence.”
Read more about ATTR-CM testing and diagnosis
ATTR-CM results from the abnormal accumulation of misfolded protein in the heart, disrupting its proper function.
The study sought to appraise the performance of SGLT2is in ameliorating the manifestations of ATTR-CM. While a number of therapies have become available for managing ATTR-CM, SGLT2is have largely been excluded from clinical trials, despite studies showing that they can reduce hospitalizations related to heart failure and improve cardiac function, the study said.
Researchers looked at available studies published on the subject and found five studies that explored the use of SGLT2is in managing ATTR-CM.
The studies encompassed a total of 9,766 patients. The research team found that the use of SGLT2is was associated with a decrease in all-cause mortality compared with patients who were not on the drug.
In addition, patients who were administered SGLT2is had lower hospitalizations and deaths due to cardiovascular disease compared with nonusers, the study said.
Patients on SGLT2is also had a lower risk of cardiac rhythmic disease and major adverse cardiovascular events compared with patients who were not prescribed the drug.
Sign up here to get the latest news, perspectives and information about ATTR-CM sent directly to your inbox. Registration is free and only takes a minute.
