SGLT2 Inhibitors in Cardiovascular and Renal Protection

Introduction to SGLT2 Inhibitors

The American Diabetes Association recommends SGLT2 inhibitors, such as empagliflozina and dapagliflozina, for patients with type 2 diabetes and established cardiovascular disease, due to their benefits in reducing cardiovascular and renal risk 1, 2

Empagliflozina reduces cardiovascular mortality by 38% in patients with type 2 diabetes and established cardiovascular disease, according to the EMPA-REG OUTCOME study 3
Dapagliflozina reduces the risk of worsening heart failure or cardiovascular death by 26% in patients with heart failure with reduced ejection fraction, as shown in the DAPA-HF study 1, 2
The American College of Cardiology recommends dapagliflozina for patients with heart failure with reduced ejection fraction, regardless of diabetes status, due to its benefits in reducing hospitalizations and cardiovascular death 1, 2

Empagliflozina is recommended for patients with chronic kidney disease (eGFR 20-60 mL/min/1.73 m²) to minimize the progression of kidney disease 4
Dapagliflozina reduces the risk of sustained decline in eGFR and end-stage kidney disease in adults with chronic kidney disease at risk of progression 5

Dapagliflozina is dosed at 5 mg once daily, with the possibility of increasing to 10 mg once daily 5
Empagliflozina is dosed at 10-25 mg once daily 4

Both empagliflozina and dapagliflozina increase the risk of genital mycotic infections, which can be managed with hygiene counseling 5, 4
The American Diabetes Association recommends monitoring for signs of ketoacidosis and urinary tract infections when using SGLT2 inhibitors 5, 4

Patients without diabetes using dapagliflozina for heart failure or chronic kidney disease do not have a risk of hypoglycemia 5
In patients with eGFR <20 mL/min/1.73 m², end-stage kidney disease, or dialysis, neither empagliflozina nor dapagliflozina is indicated 4