Sodium-glucose cotransporter-2 (SGLT2) inhibitors, which are medications that lower blood sugar levels among other effects, provide kidney- and heart-related benefits to patients with and without diabetes. An exploratory analysis recently uncovered the effects of sotagliflozin, a dual SGLT1 and 2 inhibitor, in patients with type 2 diabetes and chronic kidney disease. The research will be presented at ASN Kidney Week 2023 November 1–November 5.
The analysis involved data from the SCORED trial, a phase 3, double-blind, placebo-controlled study that randomized 10,584 patients with type 2 diabetes, chronic kidney disease, and cardiovascular factors to receive sotagliflozin or placebo. The outcomes assessed included kidney and cardiorenal composites derived using laboratory values.
Over a median follow-up of 16 months, 223 events were identified, and sotagliflozin reduced the risk of the composite of sustained ≥50% decline in estimated glomerular filtration rate, estimated glomerular filtration rate <15 mL/min/1.73m2, dialysis, or kidney transplant by 38%. Sotagliflozin also reduced the risk of a cardiorenal composite outcome (the above composite plus cardiovascular- or kidney-related death) by 23%.
These effects are consistent with what has been reported with other SGLT inhibitors in people with type 2 diabetes at high cardiorenal risk and add to the already reported benefits of sotagliflozin in reducing both heart failure and ischemic events such as myocardial infarction or stroke. Sotagliflozin is now FDA approved under the name 'INPEFA' to reduce the risk of cardiovascular death and heart failure events with a broad label that includes patients with heart failure or chronic kidney disease, so the drug is now an option for nephrologists and cardiologists, as well as primary care physicians, to prescribe."
David Cherney, MD CM, PhD, FRCP(C), corresponding author, University of Toronto