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doi:10.22028/D291-36859
Titel: | Side effects and treatment initiation barriers of sodium-glucose cotransporter 2 inhibitors in heart failure: a systematic review and meta-analysis |
VerfasserIn: | Vukadinović, Davor Abdin, Amr Anker, Stefan D. Rosano, Giuseppe M. C. Mahfoud, Felix Packer, Milton Butler, Javed Böhm, Michael |
Sprache: | Englisch |
Titel: | European Journal of Heart Failure |
Verlag/Plattform: | Wiley |
Erscheinungsjahr: | 2022 |
Freie Schlagwörter: | Sodium–glucose cotransporter 2 inhibitors Heart failure Adverse events Renal function |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
Abstract: | Aims Physicians are sometimes reluctant to initiate guideline-directed therapy in patients with heart failure and reduced ejection fraction (HFrEF) due to concerns of adverse events. We explored the risk of hypotension, volume depletion, and acute kidney injury (AKI) on sodium–glucose cotransporter 2 (SGLT2) inhibitors in HFrEF populations. Methods and results We determined summary risk ratios (RRs) by conducting a meta-analysis on reported aforementioned adverse events on SGLT2 inhibitors from randomized controlled trials. We explored robustness of meta-analyses by computing fragility and/or reverse fragility index (FI or RFI) and its corresponding fragility quotient (FQ or RFQ) for each outcome. A total of 10 050 patients with HFrEF entered the final meta-analysis. Hypotension was reported in 4.5% (219/4836) on SGLT2 inhibitors and in 4.1% (202/4846) on placebo (RR 1.09, 95% confidence interval [CI] 0.91–1.31, p = 0.36). An RFI of 21 and RFQ of 0.002 suggest robust findings for hypotension. Volume depletion occurred in 9.4% (473/5019) on SGLT2 inhibitors and in 8.7% (438/5031) on placebo (RR 1.07, 95% CI 0.95–1.21, p = 0.25), respectively. RFI of 19 and RFQ of 0.001 suggest moderately robust findings for volume depletion. AKI was reported in fewer patients (1.9% [95/4888]) on SGLT2 inhibitors than on placebo (2.8% [140/4899]) providing lower incidence of AKI (RR 0.69, 95% CI 0.51–0.93, p = 0.02). FI of 14 and RFQ of 0.001 suggest moderately robust findings for AKI. Conclusion Sodium–glucose cotransporter 2 inhibitor therapy is not associated with a clinically relevant risk of hypotension and volume depletion. Its use reduces the risk of AKI. This analysis supports current guideline recommendations on early use of SGLT2 inhibitors. |
DOI der Erstveröffentlichung: | 10.1002/ejhf.2584 |
URL der Erstveröffentlichung: | https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2584 |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-368595 hdl:20.500.11880/33489 http://dx.doi.org/10.22028/D291-36859 |
ISSN: | 1879-0844 1388-9842 |
Datum des Eintrags: | 18-Jul-2022 |
Bezeichnung des in Beziehung stehenden Objekts: | Supporting Information |
In Beziehung stehendes Objekt: | https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fejhf.2584&file=ejhf2584-sup-0001-Supinfo.pdf |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Innere Medizin |
Professur: | M - Prof. Dr. Michael Böhm |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Dateien zu diesem Datensatz:
Datei | Beschreibung | Größe | Format | |
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European J of Heart Fail - 2022 - Vukadinovi - Side effects and treatment initiation barriers of sodium glucose.pdf | 1,63 MB | Adobe PDF | Öffnen/Anzeigen |
Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons