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Jardiance (empagliflozin)
Jardiance (empagliflozin)
Also see "SGLT2
Inhibitors".
Related Topics:
Where to purchase:
News & Research:
-
Moving the Needle: SGLT2
Inhibitor Role for Isolated Kidney Disease - Medscape, 11/4/22 -
"In the new trial, EMPA-Kidney, treatment with
empagliflozin 10 mg daily for a median of 2.0 years led to a significant 28%
relative risk reduction in the primary combined endpoint in comparison with
placebo" - See
empagliflozin inhousepharmacy.vu.
-
Empagliflozin and Elderly
Patients With Preserved Ejection Fraction Heart Failure: Is Age Just a Number?
- Medscape, 10/17/22 - "Major molecular regulators of
cellular lifespan are sirtuin-1 (SIRT1) and mammalian target of rapamycin
complex 1 (mTORC1). In a nutrient-deficient or calorie-restricted state, SIRT1
activation, along with adenosine monophosphate-activated protein kinase (AMPK)
and peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α) set
forth a cascade of downstream target activations culminating in deceleration of
cell aging. Suppression of the mTORC1 pathway further augments SIRT1-activated
autophagy, the lysosome-utilizing process of clearing misfolded proteins from
the cytosol. Without healthy autophagy, oxidative stress contributes to impaired
endothelial nitric oxide (NO) pathways, inflammation, cell death, fibrosis, and
cardiomyopathy (adapted from Gevaert et al1). SGLT2 inhibitors are hypothesized
to contribute to activation of SIRT1 and suppression of mTORC1 pathways.10 Akt =
protein kinase B; HFpEF = heart failure with preserved ejection fraction; ROS =
reactive oxygen species ... Aside from the obvious bedside clinical
implications, the findings of Bohm et al[7] cause us to wonder more about the
mechanistic impact of SGLT2 inhibition on multiple cardiovascular and
noncardiovascular therapeutic targets. SGLT2 inhibitors induce glycosuria and
reduce insulin levels, which promotes a ketogenic and fatty acid oxidation
state, mimicking calorie restriction physiology, which has been associated with
cellular stress resistance, attenuation of cellular senescence, and reduced
oxidative stress-induced tissue damage.[9] Such pathway activation is
hypothesized to assuage metabolic disease, alleviate endothelial and vascular
inflammation, and mitigate the clinically observed arterial stiffness associated
with the HFpEF syndrome" - See
empagliflozin inhousepharmacy.vu.
-
Empagliflozin and Elderly
Patients With Preserved Ejection Fraction Heart Failure: Is Age Just a Number?
- Medscape, 10/17/22 - "Major molecular regulators of
cellular lifespan are sirtuin-1 (SIRT1) and mammalian target of rapamycin
complex 1 (mTORC1). In a nutrient-deficient or calorie-restricted state, SIRT1
activation, along with adenosine monophosphate-activated protein kinase (AMPK)
and peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α) set
forth a cascade of downstream target activations culminating in deceleration of
cell aging. Suppression of the mTORC1 pathway further augments SIRT1-activated
autophagy, the lysosome-utilizing process of clearing misfolded proteins from
the cytosol. Without healthy autophagy, oxidative stress contributes to impaired
endothelial nitric oxide (NO) pathways, inflammation, cell death, fibrosis, and
cardiomyopathy (adapted from Gevaert et al1). SGLT2 inhibitors are hypothesized
to contribute to activation of SIRT1 and suppression of mTORC1 pathways.10 Akt =
protein kinase B; HFpEF = heart failure with preserved ejection fraction; ROS =
reactive oxygen species ... Aside from the obvious bedside clinical
implications, the findings of Bohm et al[7] cause us to wonder more about the
mechanistic impact of SGLT2 inhibition on multiple cardiovascular and
noncardiovascular therapeutic targets. SGLT2 inhibitors induce glycosuria and
reduce insulin levels, which promotes a ketogenic and fatty acid oxidation
state, mimicking calorie restriction physiology, which has been associated with
cellular stress resistance, attenuation of cellular senescence, and reduced
oxidative stress-induced tissue damage.[9] Such pathway activation is
hypothesized to assuage metabolic disease, alleviate endothelial and vascular
inflammation, and mitigate the clinically observed arterial stiffness associated
with the HFpEF syndrome" - See
empagliflozin inhousepharmacy.vu.
-
Early Flozin Use Tied to
Improved LA Strain in ACS With Diabetes - Medscape, 7/5/22 -
"The addition of the SGLT2 inhibitor empagliflozin to
routine acute coronary syndrome (ACS) medications significantly improved left
atrial (LA) reservoir and contractile strain. These changes were not seen in
most conventional diastolic function markers or in patients who did not receive
the agent ... SGLT2 inhibitors might be unique among glucose-lowering agents in
their ability to improve diastolic cardiac remodeling"
-
Empagliflozin Eyed for
Outpatient Chronic Hyponatremia - Medscape, 6/21/22 -
"Empagliflozin is a potential treatment for outpatients
with chronic hyponatremia due to the syndrome of inappropriate antidiuresis
(SIAD) ... Hyponatremia, defined as a serum sodium level below 135 mmol/L, is
the most common electrolyte disorder in both the inpatient and outpatient
settings. SIAD is one of its main causes, whereby impaired antidiuretic hormone
regulation leads to a reduction in free water excretion and water retention in
the kidney, with subsequent hypotonic hyponatremia ... Serum sodium levels
remained stable with placebo while increasing from 130 mmol/L to 134 mmol/L with
empagliflozin, giving a corresponding treatment effect of 4.1 mmol/L (P = .004).
The increase took place during the first week of treatment and plasma sodium
levels remained stable through subsequent weeks ... there's accumulating
evidence that these patients have cognitive impairments such as attention
deficit, that they are unstable when walking with a propensity to fall, and that
they have increased risk for osteoporosis and fractures, and even death"
- Note: Sounds like that could be a bad think if you blood sodium is high.
-
SGLT2 Inhibitors Cut AFib
Risk in Real-Word Analysis - Medscape, 6/14/22 -
"But despite documentation like this, real-world evidence also continues to show
limited uptake of SGLT2 inhibitors in U.S. patients with type 2 diabetes.
Records from more than 1.3 million patients with type 2 diabetes managed in the
Veterans Affairs Healthcare System during 2019 or 2022 documented that just 10%
of these patients received an agent from this class, even though all were
eligible to receive it, according to findings in a separate report at the
meeting ... The study's primary endpoint was the incidence of hospitalization
for AFib, which occurred a significant 18% less often in the patients who
started on an SGLT2, compared with those who started a DPP4 inhibitor during
median follow-up of 6.7 months, and a significant 10% less often, compared with
those starting a GLP-1 receptor agonist during a median follow-up of 6.0 months
... in an analysis of more than 130,000 matched pairs, treatment with
empagliflozin was linked to a significant 30% reduction in the incidence of
hospitalization for heart failure, compared with patients treated with a GLP-1
receptor agonist. Analysis of more than 116,000 matched pairs of patients showed
that treatment with empagliflozin linked with a significant 29%-50% reduced rate
of hospitalization for heart failure, compared with matched patients treated
with a DPP4 inhibitor" - See
empagliflozin inhousepharmacy.vu.
-
Dapagliflozin Early
Benefit Explored in Reduced-EF Heart Failure - Medscape, 6/6/22 -
"Functional capacity in heart failure with reduced ejection fraction (HFrEF)
appears to improve within a few weeks of SGLT2-inhibitor initiation, suggests a
small, randomized study that followed peak VO2 in patients with HFrEF assigned
to take dapagliflozin (Farxiga). The benefit observed at 30 days held at a
plateau for at least a few more months ... The new study, called DAPA-VO2 , has
limitations but is consistent with a similar study of empagliflozin (Jardiance),
investigators observed, and could help explain why clinical risk fell off so
rapidly once patients started on SGLT2 inhibitors in major HFrEF trials of these
drugs ... Peak VO2 in the study rose 8% further (P = .021) in patients on
dapagliflozin compared with placebo a month into the trial, the gain persisting
at least to 90 days" - See
empagliflozin inhousepharmacy.vu.
-
Empagliflozin Rapidly
Improves Acute Heart Failure Symptoms in Hospitalized Patients - Medscape,
4/14/22 - "The trial randomized patients hospitalized
for acute heart failure after a brief period of stabilization regardless of
their left ventricular ejection fraction or presence of diabetes to receive a
single, daily dose of 10 mg of empagliflozin (Jardiance) or placebo starting a
median of 3 days after admission ... Using a “win ratio” method for analyzing
the composite endpoint, the primary analysis showed that treatment with
empagliflozin for 90 days boosted the win ratio by a significant 36% relative to
placebo (Nature Med. 2022 Mar;28[3]: 568-74) ... EMPULSE is the second trial to
show that an SGLT2 inhibitor can safely and effectively treat patients
hospitalized for acute heart failure. Previously, results from the SOLOIST-WHFpivotal
trial, which enrolled 1,222 patients with type 2 diabetes recently hospitalized
for worsening heart failure, showed that treatment with an investigational,
combined SGLT2 and SGLT1 inhibitor, sotagliflozin, resulted in a significant,
33% relative reduction in the primary outcome compared with placebo after a
median 9 months of treatment." -
See
empagliflozin inhousepharmacy.vu.
-
Heart Failure With
Preserved Ejection Fraction: New Treatments Provide 'Hope' - Medscape,
3/28/22 - "That is, those individuals in PARAGON-HF who
had ejection fractions slightly on the lower end of "normal" tended to benefit
more from this medication as well. That differentiated by sex. This is a
controversial aspect of the field and it is something that's evolving on a
day-to-day or month-to-month basis ...
Sacubitril-valsartan, I
think, would be a medicine that could be of particular benefit in this patient.
That was the first of the next few trials in HFpEF
that started to yield potential new drug classes for HFpEF. ... The next drug
class is one with which all aspects of cardiology have become more and more
aware, and the HFpEF field is no stranger. With the results of the
EMPEROR-Preserved trial we have, in the history of HFpEF clinical trials, our
first positive trial, and a monumental moment. A trial evaluating the efficacy
of empagliflozin (a sodium-glucose cotransporter 2 [SGLT2] inhibitor) vs placebo
in HFpEF. This is the ideal patient who may benefit from this medicine ...
EMPEROR-Preserved demonstrated a reduction in a composite endpoint of heart
failure hospitalization and cardiovascular death. As you mentioned, Clyde, this
efficacy was driven by a reduction in heart failure hospitalization. The class
of SGLT2 inhibitors would be, certainly, a medicine that would provide much
benefit not only from a reduction in heart failure hospitalization perspective,
but a marked improvement in symptoms"
-
Empagliflozin and decreased
risk of nephrolithiasis: A potential new role for SGLT2 inhibition? - J Clin
Endocrinol Metab 2022 Mar 15 - "Diabetes mellitus is a
risk factor for nephrolithiasis. A recent observational study found that SGLT2
inhibitor use by type 2 diabetes (T2D) patients was associated with a 49% lower
risk of nephrolithiasis, compared to GLP-1 receptor agonist ... Compared to
placebo, empagliflozin therapy was associated with an approximate 40% reduced
risk of urinary tract stone events in T2D patients"
-
Empagliflozin Scores
Topline Win in EMPA-KIDNEY Trial - Medscape, 3/17/22 - "EMPA-KIDNEY
is the third major trial of an agent from the sodium-glucose co-transport 2
(SGLT2) inhibitor class tested in patients with CKD to be stopped early because
of positive results that met a prespecified termination rule ... The success of
empagliflozin in EMPA-KIDNEY follows its positive results in both the
EMPEROR-Reduced and EMPEROR-Preserved trials, which collectively proved the
efficacy of the agent for patients with heart failure regardless of their left
ventricular ejection fraction and regardless of whether they also had diabetes"
-
FDA Okays Empagliflozin
for HF Regardless of Ejection Fraction - Medscape, 2/24/22 -
"That means the SGLT2 inhibitor, once considered
primarily an antidiabetic agent, is approved for use in patients with HF per se
without regard to ventricular function ... The study saw a significant 21%
relative reduction in that composite endpoint over about 2 years in patients
with NYHA class II-IV heart failure and an LVEF greater than 40% who received
empagliflozin along with other standard care"
-
SGLT2 Inhibitors in Older
Adults with Heart Failure with Preserved Ejection Fraction - Drugs Aging
2022 Feb 4 - "Until now, empagliflozin is the first
therapy that has convincingly been shown to improve clinical outcome in HFpEF.
Importantly, some key points should be considered to better understand the
impact of empagliflozin on the patient trajectory, particularly in older adults
with HFpEF. In this current opinion article, we have therefore provided more
information on how to translate the findings of the EMPEROR-Preserved trial to
the setting of older adults, with a focus on the impact of empagliflozin on
hospitalizations, both heart failure-related and all-cause. To better understand
the importance of EMPEROR-Preserved findings, we compared these findings with
previous relevant HFpEF and heart failure with reduced ejection fraction (HFrEF)
trials and provided information on ongoing trials in the HFpEF setting"
-
The
diabetes medication that could revolutionize heart failure treatment -
Science Daily, 12/1/21 - "For many years there was not a
single medicine that could improve the outcome in patients with the second type
of heart failure -- those patients with preserved ejection fraction ... SGLT2
inhibitors are more commonly known under their trade-names Forxiga
(Dapagliflozin), Invokana (Canagliflozin), and Jardiance (Empagliflozin) ... We
found that patients taking SGLT2 inhibitors were 22 per cent less likely to die
from heart-related causes or be hospitalised for heart failure exacerbation than
those taking placebo" - See
dapagliflozin at reliablerxpharmacy.com.
-
EMPEROR-Preserved Findings
Confirmed in 'True' HFpEF Patients - Medscape, 11/18/21 -
"The demonstration that empagliflozin is an effective —
and safe — treatment for patients with HFpEF not only provides a new treatment
for a disorder that until now had no evidence-based intervention, but also
streamlines the management approach for treating patients with heart failure
with an agent from empagliflozin's class, the SGLT2 inhibitors ... The impact of
empagliflozin, compared with placebo, for reducing both the study's combined,
primary outcome as well as total HHF was statistically consistent across all
strata of LVEF, from 50% to greater than 70% ... Patients' quality of life as
measured by the Kansas City Cardiomyopathy Questionnaire showed a consistent
benefit from empagliflozin treatment, compared with placebo, both in patients
with an LVEF of at least 50% as well as in those with an LVEF of 41%-49% ...
Deterioration of renal function on treatment slowed by an average 1.24 mL/min
per 1.73 m2 per year in patients on empagliflozin, compared with placebo, in the
subgroup with an LVEF of at least 50%"
-
Empagliflozin a Winner in
Challenging Arena of Stabilized Acute HF - Medscape, 11/16/21 -
"Patients assigned to empagliflozin had a 36% greater
likelihood of showing a benefit as reflected in the treatment's win ratio when
opposed by placebo ... The trial also lends new weight to the strategy of
"simultaneous or rapid-sequence initiation" of the so-called four pillars of
guideline-directed medical therapy of HF with reduced ejection fraction (HFrEF)
in patients hospitalized with HFrEF, once they are stabilized, Fonarow said. The
four-pronged approach, he noted, consists of sacubitril/valsartan (Entresto), a
beta blocker, a mineralocorticoid receptor antagonist (MRA), and an SGLT2
inhibitor ... EMPULSE entered patients hospitalized for acute HF, which could be
de novo or a decompensation of chronic HF, without regard to ejection fraction
or whether they had diabetes, and who were clinically stable after at least one
dose of loop diuretics. Their ejection fractions averaged 35% and exceeded 40%
in about one third of the total cohort ... At 90 days in the win ratio analysis,
the 265 patients assigned to empagliflozin 10 mg once daily were the "winners,"
that is, they were more likely to show a clinical benefit about 54% of the time
in paired match-ups of patient outcomes, compared to about 40% for the 265 in
the control group ... The empagliflozin group also benefited significantly for
the endpoint of death from any cause or first HF event, with a hazard ratio (HR)
of 0.65 (95% CI, 0.43 - 0.99, P = .042). They also were less likely to
experience acute renal failure (7.7% vs 12.1% for the control group) or serious
adverse events (32.3% vs 43.6%), Voors reported ... several ongoing trials are
exploring dapagliflozin (Farxiga) in a similar clinical setting" - See
dapagliflozin at reliablerxpharmacy.com. They don't have
empagliflozin.
-
Adults with acute heart failure benefit when treated with a type 2 diabetes
medication - AHA, 11/14/21 - "When treated with
empagliflozin, adults hospitalized for acute heart failure were 36% more likely
to have a clinical benefit, such as a reduction in all-cause mortality,
reduction in heart failure events, or an improvement in heart failure symptoms"
-
Advanced CKD Doesn't
Derail Empagliflozin in EMPEROR-Preserved - Medscape, 11/12/21 -
"The results showed, in a prespecified analysis, that
treatment with empagliflozin led to a consistent, significant relative risk
reduction compared with placebo in the primary endpoint of cardiovascular death
or hospitalization for heart failure "across the full spectrum of kidney
function, down to an eGFR of 20 mL/min/1.73m2," said Faiez Zannad, MD, PhD, who
presented the findings at virtual Kidney Week 2021 ... Among the 46.5% of
enrolled patients without CKD, empagliflozin produced a significant 20% drop in
the primary outcome relative to those who received placebo. Among the 53.5% of
patients with CKD at time of randomization (defined as an eGFR < 60 mL/min/1/73m2
or a urinary albumin to creatinine ratio > 300 mg/g), treatment with
empagliflozin was associated with a significant 25% cut in the primary endpoint
compared with placebo"
-
Empagliflozin's HFpEF
Efficacy Catalyzes Redefinition of HF - Medscape, 9/22/21 -
"This new consensus essentially throws out left
ventricular ejection fraction (EF) as the key metric for matching patients to
heart failure treatments. Experts have instead begun suggesting a more unified
treatment approach for all heart failure patients regardless of their EF ... We
encourage you to forget about ejection fraction ... We certainly encourage you
to forget about an ejection fraction of less than 40%" as having special
significance ... The 40% ejection fraction divide is artificial. It was created
in 2003 as part of a trial design, but it has no physiological significance ...
A much better way to distinguish systolic and diastolic heart failure is by
strain assessment rather than by ejection fraction. "Strain is a measure of
myocardial shortening, a measure of what the heart does. Ejection fraction is a
measure of volume," ... Wouldn't it be easier if we said that every patient with
heart failure needs to receive one agent from each of the four [pillar] drug
classes, and put them in a polypill ... The four pillar drug classes, recently
identified as essential for patients with HFrEF but until now not endorsed for
patients with HFpEF, are the sodium-glucose cotransporter 2 (SGLT2) inhibitors,
such as empagliflozin (Jardiance); an angiotensin receptor blocker neprilysin
inhibitor compound such as sacubitril/valsartan (Entresto); beta-blockers; and
mineralocorticoid receptor antagonists such as spironolactone and eplerenone ...
The consequence is that clinicians should feel comfortable prescribing
empagliflozin to most patients with heart failure without regard to EF, even
patients with EF values in the mid-60% range ... The EMPEROR-Preserved results
showed a clear signal of attenuated benefit among patients with an EF of 65% or
greater "on a population basis," ... Recently, data from a third trial that
tested sacubitril/valsartan in patients with HFpEF, PARAGON-HF, showed benefit
among patients with EFs below the study median of 57%"
-
FDA Okays
Empagliflozin for HFrEF - Medscape, 8/19/21 -
"The FDA based its decision on results from the EMPEROR-Reduced study, first
reported in August 2020, that showed treatment of patients with HFrEF with
empagliflozin on top of standard therapy for a median of 16 months cut the
incidence of cardiovascular death or hospitalization for worsening heart
failure by 25% relative to placebo, and by an absolute 5.3%, compared with
placebo-treated patients ... Patients enrolled in EMPEROR-Reduced had
chronic heart failure in New York Heart Association functional class II-IV
and with a left ventricular ejection fraction of 40% or less, the standard
ejection fraction criterion for defining HFrEF. Half the enrolled patients
had diabetes, and analysis showed no heterogeneity in the primary outcome
response based on diabetes status at enrollment ... Subsequent to the report
of results from the EMPEROR-Reduced trial nearly a year ago, heart failure
experts declared that treatment with an agent from the SGLT2 inhibitor class
had become a "new pillar of foundational therapy for HFrEF," and they urged
rapid initiation of an SGLT2 inhibitor (along with other appropriate
medications) at the time of initial diagnosis of HFrEF"
-
Tips for Navigating
Prior Authorization and Out-of-Pocket Costs for HFrEF Medications -
Medscape, 5/11/21 - "Moreover, in the past decade, a
series of large randomized trials have shown the efficacy of newer classes
of medications in improving health outcomes of patients with HFrEF. These
newer medications include the I f inhibitor ivabradine (SHiFT study); the
angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan
(PARADIGM-HF and PIONEER-HF trials); the sodium-glucose transporter 2
(SGLT2) inhibitors dapagliflozin (DAPA-HF study) and empagliflozin
(EMPEROR-Reduced trial); and the soluble guanylate cyclase activator
vericiguat (VICTORIA trial) ... Although these new treatment options for
HFrEF are proven to be safe and well tolerated across a wide range of
patients, there are obstacles to their widespread use — namely, the high
cost of these drugs, prior authorization requirements, and out-of-pocket
fees. Not only must patients often first obtain approval from their
insurance companies for these prescriptions, but they are also required to
pay greater out-of-pocket costs for them than generic drugs. Perhaps not
surprisingly, the use of generic ACE inhibitors and beta-blockers for HFrEF
remains high, whereas uptake of ivabradine and sacubitril-valsartan
continues to be slow and SGLT2 inhibitors are only just beginning to be
prescribed." - See
dapagliflozin at ReliableRXPharmacy. They don't carry
empagliflozin, which in my view is better. I read somewhere that India
would no longer sell generic versions after a certain patent date until that
drug goes generic. I think that's the problem with buying generic
empagliflozin from India.
-
Diabetes Drug Can Treat and Reverse Heart Failure and Reduce
Hospitalizations - mountsinai.org - "Roughly 80
percent of the patients treated with empagliflozin showed significant
improvement, and their hearts returned to near normal, the researchers
found. This group had a 16.6 percent improvement in left ventricular
ejection fraction at the six-month mark and their hearts pumped blood in a
stronger way. Their hearts became smaller, less dilated because of less
congestion and less fluid accumulation in the body, meaning that their heart
failure became less severe, and the walls of the heart were less thick,
meaning that the left ventricle could pump blood more easily"
-
Which Antidiabetic
Drug Class is Most Renoprotective? - Medscape, 12/2/20 -
"All three of the newer drug classes performed
better than the sulfonylureas. Both SGLT2i and GLP-1a offered greater
renoprotection than DPP-4i, but neither was notably better than the other,
according to the analysis. These findings held for patients at various
levels of early and advanced chronic kidney disease and were independent of
whether the patients were taking metformin" - Note: Jardiance is a
SGLT2 inhibitor.
-
SCORED and
FIDELIO-DKD: Time for Cardiologists to Help, Not Hurt, the Kidney -
Medscape, 11/20/20 - 20 minute video on
empagliflozin (Jardiance).
I doubt if most cardiologists are even aware of this yet. -
"In terms of heart failure with reduced EF, these
are really well-tolerated medicines. I've been using dapagliflozin and
empagliflozin in my patients and found them to have good clinical outcomes
and to be clinically well tolerated, with minimal side effects"
-
Diabetes drug can treat and reverse heart failure and reduce hospitalizations
- Science Daily, 11/16/20 - "Empagliflozin, a recently
developed diabetes drug ... this medication can improve the heart's size, shape,
and function, leading to better exercise capacity and quality of life, which
will reduce hospitalizations for heart
failure patients" - Note: It's a
$500/month medication.
-
EMPEROR-Reduced:
Empagliflozin's HFrEF Benefit Holds Steady on Top of Sacubitril/Valsartan -
Medscape, 10/7/20 - "When there are two very
effective treatments, it's common for people to ask: Which should I use?' The
goal of my presentation was to emphasize that the answer is both. We shouldn't
choose between neprilysin inhibition [sacubitril inhibits the enzyme neprilysin]
and SGLT2 [sodium-glucose transporter 2] inhibition; we should use both"
Abstracts:
-
Empagliflozin ameliorates
atherosclerosis via regulating the intestinal flora - Atherosclerosis 2023
Mar 20 - "Empagliflozin seems to mitigate
atherosclerosis partly by regulating intestinal microbiota"
- See
empagliflozin inhousepharmacy.vu.
-
Effects of empagliflozin on
left ventricular diastolic function in addition to usual care in individuals
with type 2 diabetes mellitus-results from the randomized, double-blind,
placebo-controlled EmDia trial - Clin Res Cardiol 2023 Feb 10 -
"After 12 weeks of intervention, empagliflozin resulted
in a significant higher decrease in the primary endpoint E/e´ ratio by - 1.18
([95% confidence interval (CI) - 1.72/- 0.65]; P < 0.0001) compared with
placebo. The beneficial effect of empagliflozin was consistent across all
subgroups and also occurred in subjects with heart failure and preserved
ejection fraction (n = 30). Additional effects of empagliflozin on body weight,
HbA1c, uric acid, red blood cell count, hemoglobin, mean corpuscular hemoglobin,
and hematocrit were detected (all P < 0.001). Approximately one-third of the
reduction in E/e´ by empagliflozin could be explained by the variables examined"
-
Low-Dose Empagliflozin as
Adjunct to Hybrid Closed-Loop Insulin Therapy in Adults With Suboptimally
Controlled Type 1 Diabetes: A Randomized Crossover Controlled Trial -
Diabetes Care 2022 Nov 4 - "Empagliflozin at 2.5 and 5
mg increased time in range during hybrid closed-loop therapy by 11-13 percentage
points compared with placebo in those who otherwise were unable to attain
glycemic targets. Future studies are required to assess long-term efficacy and
safety"
-
The SGLT2 inhibitor
empagliflozin reduces tissue sodium content in patients with chronic heart
failure: results from a placebo-controlled randomised trial - Clin Res
Cardiol 2022 Oct 26 - "This trial showed a significant
decrease in skin sodium content after 1 and 3 months of treatment with
empagliflozin. The decrease in skin sodium content may reflect a decrease in
subclinical micro-oedema or/and in non-osmotic bound tissue sodium, both
reported to impair left ventricular function"
-
Serum Uric Acid Lowering
With Empagliflozin in Heart Failure With Reduced Ejection Fraction -
Medscape, 10/26/22 - "SUA was reduced by an average of
1.12 mg/dL (66.2 μmol/L) with empagliflozin vs. placebo in this study, a
relatively modest reduction compared with that achievable with xanthine oxidase
inhibitors such as allopurinol.[12] However, the modest reduction in urate in
EMPEROR-Reduced was associated with a significant 32% reduction in adverse gout
outcomes. This is important because hyperuricaemia, and also clinical gout,
often co-exist with heart failure, and this causes difficulties with therapeutic
choices in the management of patients, particularly with diuretics that can
worsen hyperuricaemia. Empagliflozin treatment in EMPEROR-Reduced was also
associated with an impressive 30% reduction in hospitalizations for heart
failure, which was the main driver of the 25% reduction in the primary outcome
of first hospitalization for heart failure or cardiovascular death. However,
interestingly, this finding was independent of the decrease in SUA observed with
empagliflozin therapy"
-
Early Signal of Benefit
for Empagliflozin in Acute MI: EMMY - Medscape, 9/2/22 -
"SGLT2 inhibitors have shown benefits in patients with
heart failure (HF) across the spectrum of left ventricular function, reducing
the risk for HF hospitalization and cardiovascular death in low ejection
fraction (EF) in last year's EMPEROR-Preserved and the newly reported DELIVER
trial. SGLT2 inhibitors also lower the risk for incident HF in such high-risk
groups as those with type 2 diabetes or chronic kidney disease ... Left
ventricular EF improved in both groups, with those assigned to empagliflozin
having a 1.5% absolute higher EF at week 26 (P = .029). The E/e′ ratio was
significantly improved, being 6.8% lower than placebo ... The structural markers
of left ventricular end systolic volume (–7.5 mL; P = .0003) and LV end
diastolic volume (–9.7 mL; P = .0015) improved as well, and were smaller in the
empagliflozin group"
-
Empagliflozin has favourable
effect on frontal plane QRS-T angle in diabetic patients with cardiovascular
disease - J Clin Pharm Ther 2022 Jul 15 -
"Empagliflozin leads a significant narrowing in the fQRST angle in type 2 DM
patients with known CVD"
-
A metabonomics-based
renoprotective mechanism analysis of empagliflozin in obese mice - Biochem
Biophys Res Commun 2022 Jul 6 - "Our study revealed the
metabonomics-based renoprotective mechanism of empagliflozin in obese mice for
the first time. Empagliflozin may be a promising tool to delay the progression
of obesity-related kidney disease" - See
empagliflozin inhousepharmacy.vu.
-
Uric acid and sodium-glucose
cotransporter-2 inhibition with empagliflozin in heart failure with reduced
ejection fraction: the EMPEROR-reduced trial - Eur Heart J 2022 Jul 5 -
"Hyperuricaemia
is common in HF and is an independent predictor of advanced disease severity and
increased mortality. Empagliflozin induced a rapid and sustained reduction of
SUA levels and of clinical events related to hyperuricaemia. The benefit of
empagliflozin on the primary outcome was observed independently of SUA"
-
Empagliflozin Improves
Outcomes in Patients With Heart Failure and Preserved Ejection Fraction
Irrespective of Age - J Am Coll Cardiol 2022 Jul 5 - "Empagliflozin reduces
cardiovascular death (CVD) or heart failure (HF) hospitalization (HFH) in
patients with HF and preserved ejection fraction. ... Empagliflozin reduced
primary outcomes and first and recurrent HFH and improved symptoms across a
broad age spectrum. High age was not associated with reduced efficacy or
meaningful intolerability"
-
Empagliflozin for Heart
Failure With Preserved Left Ventricular Ejection Fraction With and Without
Diabetes - Circulation 2022 Jun 28 - "In patients
with heart failure and a preserved ejection fraction enrolled in
EMPEROR-Preserved (Empagliflozin Outcome Trial in Patients With Chronic Heart
Failure With Preserved Ejection Fraction), empagliflozin significantly reduced
the risk of heart failure outcomes irrespective of diabetes status at baseline"
-
Could a Type 2 Diabetes
Drug Tackle Kidney Stones? - Medscape, 6/20/22 -
"Patients with type 2 diabetes who received empagliflozin, a sodium glucose
cotransporter-2 (SGLT2) inhibitor, were almost 40% less likely to have a kidney
stone than patients who received placebo during a median 1.5 years of treatment
... Because SGLT2 inhibitors increase urinary glucose excretion through reduced
renal reabsorption of glucose leading to osmotic diuresis and increased urinary
flow, they hypothesized that these therapies "may reduce the risk of upper
urinary tract stones (nephrolithiasis) by reducing the concentration of
lithogenic substances in urine.
-
SGLT2 Inhibition via
Empagliflozin Improves Endothelial Function and Reduces Mitochondrial Oxidative
Stress: Insights From Frail Hypertensive and Diabetic Patients -
Hypertension 2022 Jun 15 - "Frailty is a
multidimensional condition often diagnosed in older adults with hypertension and
diabetes, and both these conditions are associated with endothelial dysfunction
and oxidative stress ... Taken together, our data indicate that empagliflozin
reduces frailty in diabetic and hypertensive patients, most likely by decreasing
mitochondrial reactive oxygen species production in endothelial cells"
-
The effects of
empagliflozin, dietary energy restriction, or both on appetite-regulatory gut
peptides in individuals with type 2 diabetes and overweight or obesity: the
SEESAW randomised, double-blind, placebo-controlled trial - Diabetes Obes
Metab 2022 Apr 19 - "68 adults (age 30-75 years) with
T2D (drug naïve or on metformin monotherapy; HbA1c 6.0-10.0% [42-86mmol/mol])
and BMI ≥25kg/m2 were randomised to: (1) placebo-only, (2) placebo-plus-diet,
(3) empagliflozin-only, or (4) empagliflozin-plus-diet for 24 weeks ... The mean
weight loss in each group at 24 weeks was 0.44, 1.91, 2.22, and 5.74 kg,
respectively"
-
Cardiovascular benefits of
empagliflozin are associated with gut microbiota and plasma metabolites in type
2 diabetes - J Clin Endocrinol Metab 2022 Apr 9 -
"empagliflozin may be a superior initial therapy for patients with T2DM at risk
of CVDs; its cardiovascular benefits may be associated with shifts in gut
microbiota and plasma metabolites"
-
Empagliflozin in patients
with type 2 diabetes mellitus and chronic obstructive pulmonary disease -
Diabetes Res Clin Pract 2022 Mar 18 - "In patients with
T2DM and CVD, COPD increased the risk of mortality and cardiorenal outcomes,
including HF. Empagliflozin consistently reduced these outcomes versus placebo
regardless of COPD, suggesting that empagliflozin's benefits in patients with
T2DM and CVD are not mitigated by the presence of COPD"
-
Empagliflozin Improves Cognitive Impairment in Frail Older
Adults With Type 2 Diabetes and Heart Failure With Preserved
Ejection Fraction - Diabetes Care 2022 Mar 14 -
"This study is the first to show
significant beneficial effects of the SGLT2 inhibitor
empagliflozin on cognitive and physical impairment in frail
older adults with diabetes and HFpEF"
-
Effect of empagliflozin in
patients with heart failure across the spectrum of left ventricular ejection
fraction - Eur Heart J 2021 Dec 8 - "The magnitude
of the effect of empagliflozin on heart failure outcomes was clinically
meaningful and similar in patients with ejection fractions <25% to <65%, but was
attenuated in patients with an ejection fraction ≥ 65%"
-
The effect of empagliflozin
on the total burden of cardiovascular and hospitalization events in the Asian
and non-Asian populations of the EMPA-REG OUTCOME trial of patients with type 2
diabetes and cardiovascular disease - Diabetes Obes Metab 2021 Dec 14 -
"Among 1517 Asian participants, empagliflozin reduced
relative risk of total events of the primary outcome by 38% versus placebo (rate
ratio [95% CI]: 0.62 [0.427, 0.885]), the key secondary outcome by 33% (0.67
[0.479, 0.929]), the composite of cardiovascular death (excluding fatal stroke)
and hospitalization for heart failure by 43% (0.57 [0.329, 0.996]), and
all-cause hospitalization by 21% (0.79 [0.651, 0.967]). Empagliflozin's effects
were consistent between Asian and non-Asian populations"
-
Beneficial Effect of
Sodium-Glucose Co-transporter 2 Inhibitors on Left Ventricular Function - J
Clin Endocrinol Metab 2021 Nov 15 - "Treatment with
SGLT2 inhibitors can significantly improve LV function in patients with or
without diabetes (especially those with HF or undergoing empagliflozin
treatment)"
-
Clinical benefits of
empagliflozin in very old patients with type 2 diabetes hospitalized for acute
heart failure - J Am Geriatr Soc 2021 Nov 29 -
"There is little evidence on the use of sodium-glucose cotransporter 2 (SGLT2)
inhibitors in older patients with heart failure. This work analyzed the clinical
efficacy and safety of empagliflozin continuation in very old patients with type
2 diabetes hospitalized for acute decompensated heart failure ... In very old
patients with type 2 diabetes hospitalized for acute heart failure, continuing
preadmission empagliflozin reduced NT-proBNP levels and increased diuretic
response and urine output compared to a basal-bolus insulin regimen. The
empagliflozin regimen also showed a good safety profile" - See
dapagliflozin at reliablerxpharmacy.com. They don't carry
empagliflozin.
-
Empagliflozin, Health
Status, and Quality of Life in Patients with Heart Failure and Preserved
Ejection Fraction: The EMPEROR-Preserved Trial - Circulation 2021 Nov 15 -
"Patients with heart failure and preserved ejection
fraction (HFpEF) have significant impairment in health-related quality of life (HRQoL)
... The effect of empagliflozin on reducing the risk of time to cardiovascular
death or HF hospitalization was consistent across baseline KCCQ-CSS tertiles (HR
0.83 [0.69-1.00], HR 0.70 [0.55-0.88] and HR 0.82 [0.62-1.08] for scores <62.5,
62.5-83.3 and ≥83.3, respectively; P trend=0.77). Similar results were seen for
total HF hospitalizations. Patients treated with empagliflozin had significant
improvement in KCCQ-CSS versus placebo (+1.03, +1.24 and +1.50 at 12, 32 and 52
weeks, respectively P<0.01); similar results were seen for TSS and OSS. At 12
weeks, patients on empagliflozin had higher odds of improvement ≥5 points (OR
1.23; 95%CI 1.10, 1.37), ≥10 points (1.15; 95%CI 1.03, 1.27), and ≥15 points
(1.13; 95%CI 1.02, 1.26) and lower odds of deterioration ≥5 points in KCCQ-CSS
(0.85; 95%CI 0.75, 0.97). A similar pattern was seen at 32 and 52 weeks, and
results were consistent for TSS and OSS"
-
Cost-Effectiveness of
Empagliflozin in Patients With Diabetic Kidney Disease in the United States:
Findings Based on the EMPA-REG Outcome Trial - Am J Kidney Dis 2021 Nov 6 -
"Based on EMPA-REG Outcome Study, this
cost-effectiveness analysis suggests that for commercial insurers and Medicare,
adding empagliflozin to SoC may be a cost-effective treatment option for
patients with DKD"
-
Empagliflozin Improves
Insulin Sensitivity of the Hypothalamus in Humans With Prediabetes: A
Randomized, Double-Blind, Placebo-Controlled, Phase 2 Trial - Diabetes Care
2021 Oct 29 - "Insulin action in the human brain reduces
food intake, improves whole-body insulin sensitivity, and modulates body fat
mass and its distribution. Obesity and type 2 diabetes are often associated with
brain insulin resistance, resulting in impaired brain-derived modulation of
peripheral metabolism. So far, no pharmacological treatment for brain insulin
resistance has been established. Since sodium-glucose cotransporter 2 (SGLT2)
inhibitors lower glucose levels and modulate energy metabolism, we hypothesized
that SGLT2 inhibition may be a pharmacological approach to reverse brain insulin
resistance ... We identified a significant interaction between time and
treatment in the hypothalamic response to insulin. Post hoc analyses revealed
that only empagliflozin-treated patients experienced increased hypothalamic
insulin responsiveness. Hypothalamic insulin action significantly mediated the
empagliflozin-induced decrease in fasting glucose and liver fat ... Our results
corroborate insulin resistance of the hypothalamus in humans with prediabetes.
Treatment with empagliflozin for 8 weeks was able to restore hypothalamic
insulin sensitivity, a favorable response that could contribute to the
beneficial effects of SGLT2 inhibitors. Our findings position SGLT2 inhibition
as the first pharmacological approach to reverse brain insulin resistance, with
potential benefits for adiposity and whole-body metabolism"
-
Randomized Trial of
Empagliflozin in Nondiabetic Patients With Heart Failure and Reduced Ejection
Fraction - J Am Coll Cardiol 2021 Jan 26 -
"Empagliflozin was associated with a significant reduction of LV end-diastolic
volume (-25.1 ± 26.0 ml vs. -1.5 ± 25.4 ml for empagliflozin vs. placebo,
respectively; p < 0.001) and LV end-systolic volume (-26.6 ± 20.5 ml vs. -0.5 ±
21.9 ml for empagliflozin vs. placebo; p < 0.001). Empagliflozin was associated
with reductions in LV mass (-17.8 ± 31.9 g vs. 4.1 ± 13.4 g, for empagliflozin
vs. placebo, respectively; p < 0.001) and LV sphericity, and improvements in LV
ejection fraction (6.0 ± 4.2 vs. -0.1 ± 3.9; p < 0.001). Patients who received
empagliflozin had significant improvements in peak O2 consumption (1.1 ± 2.6
ml/min/kg vs. -0.5 ± 1.9 ml/min/kg for empagliflozin vs. placebo, respectively;
p = 0.017), oxygen uptake efficiency slope (111 ± 267 vs. -145 ± 318; p <
0.001), as well as in 6-min walk test (81 ± 64 m vs. -35 ± 68 m; p < 0.001) and
quality of life (Kansas City Cardiomyopathy Questionnaire-12: 21" - See
empagliflozin inhousepharmacy.vu.
-
Prognostic Importance of NT-proBNP
and Effect of Empagliflozin in the EMPEROR-Reduced Trial - J Am Coll Cardiol
2021 Sep 28 - "In EMPEROR-Reduced, higher baseline NT-proBNP
concentrations were associated with greater risk for adverse heart failure or
renal outcomes, but empagliflozin reduced risk regardless of baseline NT-proBNP
concentration"
-
Empagliflozin and uric acid
metabolism in diabetes: A post hoc analysis of the EMPA-REG OUTCOME tri -
Diabetes Obes Metab 2021 Sep 24 - "Empagliflozin reduced
UA levels and the composite of gout episodes or prescription of antigout
medication. These clinically important findings expand the utility of
empagliflozin as a potential antigout treatment in patients with T2D, beyond its
well-established cardio-renal benefits"
-
EMPEROR-Preserved:
Empagliflozin Scores HFpEF Breakthrough - Medscape, 8/27/21 -
"The SGLT2 inhibitor empagliflozin achieved in
EMPEROR-Preserved what no other agent could previously do: unequivocally cut the
incidence of cardiovascular death or hospitalization in patients with heart
failure and preserved ejection fraction (HFpEF) ... Treatment with empagliflozin
(Jardiance) led to a significant 21% relative reduction in the rate of
cardiovascular death or hospitalization for heart failure (HHF), compared with
placebo, among 5,988 randomized patients with HFpEF during a median 26 months of
follow-up, proving that patients with HFpEF finally have a treatment that gives
them clinically meaningful benefit, and paving the way to an abrupt change in
management of these patients, experts said ... A second sodium-glucose
cotransporter 2 (SGLT2 ) inhibitor, dapagliflozin (Farxiga), is also an option
for treating HFrEF based on results in the DAPA-HF trial, and the DELIVER trial,
still in progress, is testing dapagliflozin as a HFpEF treatment in about 6,000
patients, with results expected in 2022 ... This showed a consistent and robust
benefit from empagliflozin for reducing HHF across a wide spectrum of patients
with heart failure, ranging from patients with left ventricular ejection
fractions of less than 25% to patients with ejection fractions as high as 64%
... patients with reduced ejection fractions showed a significant 49% relative
reduction in the incidence of serious renal outcomes" - Note: If
you can't get empagliflozin,
ReliableRxPharmacy sells dapagliflozin.
-
Effects of Empagliflozin on
Erythropoiesis in Patients with Type 2 Diabetes - data from a randomized,
placebo controlled study - Diabetes Obes Metab 2021 Aug 11 -
"Sodium-glucose cotransporter-2 (SGLT2) inhibitors have
been shown to significantly reduce heart failure hospitalization (HHF) and
cardiovascular (CV) mortality in various cardiovascular outcome trials in
patients with and without type 2 diabetes mellitus (T2D). SGLT2 inhibition
further increased haemoglobin concentration and hematocrit by a yet unknown
mechanism and this increase proved as an independent predictor for the CV
benefit of these agent ... 44 patients with T2D were randomized into 2 groups
and received empagliflozin 10 mg or placebo for a period of 3 months ...
Empagliflozin increased hemoglobin concentrations and hematocrit with a delayed
time kinetic which was most likely attributable to increased erythropoiesis with
augmented iron utilization and not hemoconcentration. This might be attributable
to reduced tubular glucose reabsorption in response to SGLT2 inhibition possibly
resulting in diminished cellular stress as a mechanism for increased renal
erythropoietin secretion"
-
Effects of empagliflozin on
lipoprotein subfractions in patients with type 2 diabetes: data from a
randomized, placebo-controlled study - Atherosclerosis 2021 Jun 25 -
"Empagliflozin treatment of patients with T2D increased
LDL-C and LDL apolipoprotein B levels but had no effect on calculated LDL
particle size"
-
Usefulness of Sodium-Glucose
Cotransporter 2 Inhibitors for Primary Prevention of Heart Failure in Patients
With Type 2 Diabetes Mellitus - Am J Cardiol 2021 May 15 -
"The sodium-glucose cotransporter 2 inhibitors (SGLT2i)
empagliflozin, canagliflozin, and dapagliflozin reduce the risk of heart failure
(HF) events in patients with diabetes mellitus (DM) at high risk for HF.
Differences in HF outcomes between SGLT2i were demonstrated in a
recent-published meta-analysis ... Our findings suggest that between the
available SGLT2i, the cost of primary prevention of HF in patients with DM at
high risk for HF is lowest with empagliflozin" - See
dapagliflozin at ReliableRXPharmacy. They don't carry
empagliflozin, which in my view is better. I read somewhere that India
would no longer sell generic versions after a certain patent date until that
drug goes generic. I think that's the problem with buying generic
empagliflozin from India.
-
Effect of empagliflozin on
cardiorenal outcomes and mortality according to body-mass index: A subgroup
analysis of the EMPA-REG OUTCOME trial with a focus on Asia - Diabetes Obes
Metab 2021 May 5 - "Overall, hazard ratios for
empagliflozin versus placebo for all-cause mortality, HHF or CV death, and
incident or worsening nephropathy were 0.68 (95% CI 0.57, 0.82), 0.66 (0.55,
0.79), and 0.61 (0.53, 0.70), respectively, and were consistent across BMI
categories (P-values for interaction between treatment and BMI: 0.6772, 0.3087,
and 0.6265, respectively). Results were similar in Asians using these BMI
categories and < 24, 24 to <28, ≥28 kg/m2 categories. Thus, empagliflozin
reduced cardiorenal and mortality risk regardless of BMI at baseline, including
in Asians with lower BMI"
-
Are SGLT2 Inhibitors New
Hypertension Drugs? - Circulation 2021 May 4 - Note: See the
table. Jardiance (empagliflozin) lowered systolic by about 10 points.
Farxiga (dapagliflozin) was 5.8.
-
Cardiac and Kidney
Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney
Function - Medscape, 3/29/21 - "Empagliflozin
reduced the primary outcome and total HF hospitalizations in patients with and
without CKD: hazard ratio (HR)=0.78 (95% CI, 0.65–0.93) and HR=0.72 (95% CI,
0.58–0.90), respectively (interaction P=0.63). Empagliflozin slowed the slope of
eGFR decline by 1.11 (0.23–1.98) ml/min/1.73 m2/yr in patients with CKD and by
2.41 (1.49–3.32) ml/min/1.73 m2/yr in patients without CKD. The risk of the
composite kidney outcome was reduced similarly in patients with and without CKD:
HR=0.53 (95% CI, 0.31–0.91) and HR=0.46 (95% CI, 0.22–0.99), respectively. The
effect of empagliflozin on the primary composite outcome and key secondary
outcomes was consistent across a broad range of baseline kidney function,
measured by clinically relevant eGFR subgroups or by albuminuria, including
patients with eGFR as low as 20 ml/min/1.73 m2. Empagliflozin was well tolerated
in CKD patients ... In EMPEROR-Reduced, empagliflozin had a beneficial effect on
the key efficacy outcomes and slowed the rate of kidney function decline in
patients with and without CKD, and regardless of the severity of kidney
impairment at baseline."
-
SGLT-2 inhibitors for
prevention of cardiorenal outcomes in type 2 diabetes: an updated meta-analysis
- Diabetes Obes Metab 2021 Mar 12 - "A total of 8
cardiorenal outcomes trials of SGLT-2i (empagliflozin, canagliflozin,
dapagliflozin, ertugliflozin, sotagliflozin) were identified, with 66 601
patients ... Overall, SGLT-2i were associated with a 12% reduced risk of major
adverse cardiovascular events (MACE, HR = 0.88; 95% CI, 0.83-0.93; Q statistic,
P = 0.19), with no significant heterogeneity (p for interaction = 0.465) between
subgroups of patients with or without cardiovascular disease (CVD). The risk of
the composite renal outcome was significantly reduced by treatment with SGLT-2i
(HR = 0.61, 95% CI, 0.54-0.70), with no significant heterogeneity of
associations with outcome (I2 = 37%, P = 0.11), and no difference in the risk
between patients with or without CVD (p for interaction = 0.665). SGLT-2i have
moderate benefits on MACE and major benefits on the progression of diabetic
kidney disease"
-
The role of SGLT-2
inhibitors in managing type 2 diabetes - Cleve Clin J Med 2020 Dec 31 -
"Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are
an exceptionally versatile class of medication, and their glycemic and
nonglycemic benefits could help millions of patients with type 2 diabetes. Of
note, they have been shown to improve cardiac and renal outcomes, much-needed
benefits in patients with type 2 diabetes, who are at a higher risk for
developing cardiac and renal dysfunction than those who do not have diabetes.
The indications for SGLT-2 inhibitors may continue to expand as ongoing clinical
trials provide more insight into these drugs"
-
Effects of SGLT2 inhibitors
on eGFR in type 2 diabetic patients-the role of antidiabetic and
antihypertensive medications - Hypertens Res 2020 Dec 14 -
"metformin blunts the SGLT2i-induced decrease in eGFR,
but coadministration of RASis ameliorates this response. Furthermore, the
inability of CCBs to modify the SGLT2i-induced reduction in eGFR suggests that
the SGLT2i-induced renal microvascular action is mediated predominantly by
postglomerular vasodilation rather than preglomerular vasoconstriction"
- Note: Normal eGFR is >60. I threw this in because the diabetes medication
and SGLT2 inhibitor Jardiance (empagliflozin) is also being used to help repair
the heart in heart failure patients.
-
Randomized Trial of
Empagliflozin in Non-Diabetic Patients with Heart Failure and Reduced Ejection
Fraction - J Am Coll Cardiol 2020 Nov 9 -
"Empagliflozin administration to non-diabetic HFrEF patients significantly
improves LV volumes, LV mass, LV systolic function, functional capacity, and
quality of life when compared with placebo. Our observations strongly
support a role for SGLT2 inhibitors in the treatment of HFrEF patients
independently of their glycemic status"
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