Sodium–glucose co-transporter 2 inhibitors offer impressive cardiac and kidney outcome benefits to people with type 2 diabetes mellitus (T2DM). These benefits now appear to extend to people without T2DM, according to three trials published in 2020.
Key advances
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Empagliflozin and dapagliflozin improved heart failure outcomes and reduced the decline in estimated glomerular filtration rate for people with heart failure and reduced ejection fraction in large outcome trials; half of the participants did not have type 2 diabetes mellitus (T2DM) at treatment initiation.
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Dapagliflozin improved kidney and cardiac outcomes for people with chronic kidney disease with substantial albuminuria in a large outcome trial in which one third of people did not have T2DM at treatment initiation.
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No evidence suggests that the benefits observed within the trials differs between people with or without T2DM at treatment initiation.
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A.K. is supported by an NHMRC Postgraduate Scholarship. M.J. is supported by a Medical Research Future Fund Next Generation Clinical Researchers Program Career Development Fellowship; is responsible for research projects that have received unrestricted funding from Gambro, Baxter, CSL, Amgen, Eli Lilly and MSD; has served on advisory boards sponsored by Akebia, Astra Zeneca, Baxter, Bayer, Boehringer Ingelheim, MSD and Vifor; serves on Steering Committee for trials sponsored by Janssen and CSL; has spoken at scientific meetings sponsored by Janssen, Amgen, Roche and Vifor; with any consultancy, honoraria or travel support paid to her institution.
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Kang, A., Jardine, M.J. SGLT2 inhibitors may offer benefit beyond diabetes. Nat Rev Nephrol 17, 83–84 (2021). https://doi.org/10.1038/s41581-020-00391-2
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DOI: https://doi.org/10.1038/s41581-020-00391-2
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