The use of sodium-glucose cotransporter inhibitors (SGLTis), a drug class commonly prescribed for diabetes and heart failure, appears to decrease mortality in transthyretin amyloid cardiomyopathy (ATTR-CM) by more than 60%, according to a recently published study in Current Problems in Cardiology.
About SGLTis
SGLT2is were introduced in the early 2010s as anti-diabetic drugs. The first U.S. Food and Drug Administration (FDA)-approved SGLT2i was canagliflozin, followed shortly by dapagliflozin, empagliflozin and ertugliflozin.
These drugs bind to transporters in the kidneys responsible for reabsorbing glucose, thereby lowering blood glucose levels and offering significant benefits to patients with diabetes.
Several clinical trials have also demonstrated that SGLT2is provide positive effects in patients with heart failure, independent of their glucose-lowering properties. SGLTis reduce the incidence of major adverse cardiovascular events, hospitalizations due to heart failure and the progression of chronic kidney disease.
Although the benefits of SGLT2is in heart failure are well documented, research on their use in ATTR-CM is more recent.
Several studies show benefits of SGLTis in ATTR-CM
To further evaluate the effects of SGLT2is in patients with ATTR-CM, the authors conducted a meta-analysis. Meta-analyses combine results from multiple studies to enhance statistical power and precision.
This meta-analysis included data from five observational studies with a combined total of 5,101 patients, approximately half of whom received treatment with an SGLT2i; the remaining patients received alternative treatments and served as controls.
The analysis revealed that the use of SGLT2is was associated with a significant reduction in cardiovascular mortality and all-cause mortality. Additionally, patients taking an SGLT2i experienced fewer hospitalizations and showed lower levels of cardiac biomarkers.
The authors noted that the included studies had a moderate risk of bias, meaning that potential issues in study design, conduct or reporting could influence the results. Consequently, they recommend conducting larger randomized controlled trials to confirm these findings.
“While promising, these observational findings require confirmation in randomized trials to address potential confounding factors,” the authors concluded.
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