Patients with diabetes, worsening HF benefit from sotagliflozin at or before discharge
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In a post hoc analysis of SOLOIST-WHF, patients with type 2 diabetes hospitalized for worsening HF had lower rates of CV death and HF rehospitalization if they received sotagliflozin on or before discharge than if they did not.
“Our analysis concluded that starting sotagliflozin before discharge in patients hospitalized for worsening heart failure significantly decreased cardiovascular deaths and heart failure events,” Bertram Pitt, MD, FACC, professor of medicine emeritus at the University of Michigan School of Medicine, said in a press release. “Hospital readmissions are burdensome, time-consuming and costly. The results emphasize the importance of beginning SGLT inhibition before discharge.”
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As Healio previously reported, in the main results of SOLOIST-WHF, patients with type 2 diabetes hospitalized for worsening HF assigned the dual SGLT1/SGLT2 inhibitor sotagliflozin (Inpefa, Lexicon) had reduced risk for CV death and first and subsequent HF hospitalizations and urgent HF visits compared with those assigned placebo, with a number needed to treat of just 4.
For the present analysis of the 1,222 patients from SOLOIST-WHF (mean age, 70 years; 35% women), the researchers compared the 596 who received sotagliflozin on or before their discharge date with the rest of the cohort.
Compared with the control group, the sotagliflozin on or before discharge group had reduced risk for CV death, HF hospitalization or HF urgent care visit at 90 days (HR = 0.54; 95% CI, 0.35-0.82; P = .004) and at 30 days (HR = 0.49; 95% CI, 0.27-0.91; P = .023), as well as reduced risk for all-cause mortality at 90 days (HR = 0.39; 95% CI, 0.17-0.88; P = .024), the researchers wrote.
The results were consistent regardless of age, sex, kidney function, N-terminal pro-B-type natriuretic peptide level, left ventricular ejection fraction or mineralocorticoid receptor agonist use, according to the researchers.
Sotagliflozin was well tolerated but conferred slightly higher rates of diarrhea and adverse events associated with volume depletion, Pitt and colleagues wrote.
“These findings are the first to demonstrate a decrease in mortality and HF events for a SGLT inhibitor treatment initiated during [worsening] HF hospitalization and underscore the benefits of early initiation of evidence-based HF therapy,” they wrote.
Reference:
- Published analysis of sotagliflozin (Inpefa) clinical data demonstrates significant reductions in the risk of hospital readmissions for heart failure. https://www.lexpharma.com/media-center/news/2023-08-08-published-analysis-of-sotagliflozin-inpefa-clinical-data-demonstrates-significant-reductions-in-the-risk-of-hospital-readmissions-for-heart-failure. Published Aug. 8, 2023. Accessed Aug. 11, 2023.
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