Please use this identifier to cite or link to this item:
doi:10.22028/D291-36859
Title: | Side effects and treatment initiation barriers of sodium-glucose cotransporter 2 inhibitors in heart failure: a systematic review and meta-analysis |
Author(s): | Vukadinović, Davor Abdin, Amr Anker, Stefan D. Rosano, Giuseppe M. C. Mahfoud, Felix Packer, Milton Butler, Javed Böhm, Michael |
Language: | English |
Title: | European Journal of Heart Failure |
Publisher/Platform: | Wiley |
Year of Publication: | 2022 |
Free key words: | Sodium–glucose cotransporter 2 inhibitors Heart failure Adverse events Renal function |
DDC notations: | 610 Medicine and health |
Publikation type: | Journal Article |
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 of the first publication: | 10.1002/ejhf.2584 |
URL of the first publication: | https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2584 |
Link to this record: | 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 |
Date of registration: | 18-Jul-2022 |
Description of the related object: | Supporting Information |
Related object: | https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fejhf.2584&file=ejhf2584-sup-0001-Supinfo.pdf |
Faculty: | M - Medizinische Fakultät |
Department: | M - Innere Medizin |
Professorship: | M - Prof. Dr. Michael Böhm |
Collections: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Files for this record:
File | Description | Size | 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 | View/Open |
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