Sodium-glucose inhibitor use in PAH may have mortality benefit
Click Here to Manage Email Alerts
Key takeaways:
- A smaller proportion of patients with PAH using vs. not using a sodium-glucose cotransporter-2 (SGLT2) inhibitor died.
- More research is needed on the link found between SGLT2 inhibitor use and mortality.
BOSTON — Fewer patients with pulmonary arterial hypertension died at three time points with use of a sodium-glucose cotransporter-2 inhibitor, according to data presented at the CHEST Annual Meeting.
“[Sodium-glucose cotransporter-2 (SGLT2)] inhibitors are mostly harmless medications, and prescribing this group of medications for a large number of pulmonary hypertension patients might be considered if the results of this study are proved by further clinical trials,” Irakli Lemonjava, MD, of the department of medicine at Jefferson Einstein Hospital, told Healio.
In this study, Lemonjava and colleagues assessed 6,238 adults with PAH who used one of four SGLT2 inhibitors and 6,243 adults with PAH who did not use a SGLT2 inhibitor via TriNetX to find out how use of this class of agents impacts all-cause mortality at three follow-up visits: 1, 3 and 5 years.
The SGLT2 inhibitors included in this research were canagliflozin (Invokana, Janssen Pharmaceuticals), dapagliflozin (Farxiga, AstraZeneca), empagliflozin (Jardiance; Boehringer Ingelheim, Eli Lilly and Company) and ertugliflozin (Steglatro; Merck, Pfizer), according to the abstract.
Notably, the total group numbers came after propensity score matching, which researchers wrote factored in demographics and 10 organ system disorders.
Compared with patients not using a SGLT2 inhibitor, a smaller proportion of patients using a SGLT2 inhibitor died by the 1-year mark (15.5% vs. 8.1%). This translates into a 7.4% absolute risk reduction (RR = 0.52; 95% CI, 0.473-0.58), according to researchers.
When assessed at 3 years, this pattern continued, with fewer deaths in the group that used vs. did not use SGLT2 inhibitors (13% vs. 22.5%) and a 9.2% absolute risk reduction (RR = 0.579; 95% CI, 0.535-0.627).
Similarly, researchers observed a smaller proportion of patients who died by 5 years among those using a SGLT2 inhibitor (14.6% vs. no SGLT2 inhibitor use, 25%), yielding a 10.4% absolute risk reduction (RR = 0.583; 95% CI, 0.542-0.628).
“These are incredibly significant numbers; however, given that this study is retrospective and observational, several biases must be considered,” Lemonjava told Healio.
“Future studies, ideally prospective clinical trials, will exclude the biases that I have in my investigation,” Lemonjava added. “For example, my project does not differentiate patients based on medication doses, when in prospective trials this can be addressed properly.”
For more information:
Irakli Lemonjava, MD, can be reached at irakli.lemonjava@jefferson.edu.