medwireNews: A meta-analysis reveals that people with a poor heart failure prognosis stand to gain the most from sodium-glucose cotransporter (SGLT)2 inhibition, regardless of whether or not they have type 2 diabetes.
Treating 1000 people for 1 year would prevent 105 hospitalizations among those newly diagnosed in the hospital compared with 39 among those newly diagnosed in primary care and would prevent 23 versus 16 cardiovascular deaths, report Xinyu Zou (Sichuan University, Chengdu, China) and study co-authors.
The systematic review and meta-analysis, which is published in the Annals of Internal Medicine, included eight randomized controlled trials involving 15,022 people. Across these trials, the benefits of SGLT2 inhibition did not vary according to whether people had type 2 diabetes.
The researchers found that SGLT2 inhibitors were most impactful during approximately the first year of their use, after which the relative benefit in terms of preventing hospitalization for heart failure gradually declined. There was no significant effect on all-cause death, but the team found a significantly reduced risk for cardiovascular death and kidney outcomes. SGLT2 inhibitor use was associated with a 2.69-fold increased risk for genital infections.
“Clinicians should continuously assess the potential benefits against the risks for genital infections and whether the benefits outweigh the harms beyond the first year,” say Zou and colleagues.
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