An article by medical journalist Isabella Hornick recently published on “Healio” reports on a retrospective study which suggests that sodium-glucose cotransporter-2 (SGLT2) inhibitors may significantly reduce all-cause mortality in patients with pulmonary arterial hypertension (PAH). While these findings are promising, further prospective clinical trials are needed to confirm the results and address potential biases, according to Irakli Lemonjava, MD, and colleagues from Jefferson Einstein Hospital, the study authors.
The study utilized data from TriNetX and included 6,238 PAH patients prescribed one of four SGLT2 inhibitors—canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance), or ertugliflozin (Steglatro)—compared to 6,243 pulmonary arterial hypertension patients who did not use these medications. Propensity score matching accounted for demographics and comorbidities across 10 organ systems.
Key Findings
The findings suggest a sustained survival benefit for patients using SGLT2 inhibitors over five years.
- At 1 year: Mortality was 8.1% in SGLT2 users vs. 15.5% in non-users, with a 7.4%
absolute risk reduction (RR = 0.52; 95% CI, 0.473–0.58). - At 3 years: Mortality was 13% in SGLT2 users vs. 22.5% in non-users, resulting in a 9.2% absolute risk reduction (RR = 0.579; 95% CI, 0.535–0.627).
- At 5 years: Mortality was 14.6% in SGLT2 users vs. 25% in non-users, showing a
10.4% absolute risk reduction (RR = 0.583; 95% CI, 0.542–0.628).
Limitations and Future Directions
The study’s retrospective, observational design introduces potential biases, such as the inability to control for medication doses or detailed patient-specific factors. Dr. Lemonjava emphasized the need for prospective clinical trials to validate these results and refine the understanding of how SGLT2 inhibitors impact pulmonary arterial hypertension outcomes. If confirmed, SGLT2 inhibitors could become a viable therapeutic option for broader use in managing pulmonary arterial hypertension, a population with limited treatment options and high mortality rates.
Read more at this link on Healio.
Read the original study at this link on CHEST.
Citation of original study
IMPACT OF SGLT2 INHIBITORS ON MORTALITY IN PULMONARY ARTERIAL HYPERTENSION: EXPLORING THE ASSOCIATIONLEMONJAVA, IRAKLI et al.CHEST, Volume 166, Issue 4, A5793, DOI: 10.1016/j.chest.2024.06.3435
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