Ertugliflozin 15mg tablets

AimsSodium-glucose cotransporter-2 inhibitors (SGLT2i) are recognized for their cardiovascular benefits. This systematic review and meta-analysis evaluated the impact of SGLT2i on heart failure (HF) outcomes in cancer patients and survivors, focusing on HF hospitalization and new HF diagnoses.Methods and resultsA comprehensive search of PubMed, MEDLINE, and Embase via Ovid, and the Cochrane Library was conducted up to 5 June 2024, focusing on studies involving cancer patients and survivors treated with SGLT2i. The search criterion used was [(SGLT2) OR (Sodium glucose cotransporter 2 inhibitors) OR (canagliflozin) OR (dapagliflozin) OR (empagliflozin) OR (ertugliflozin) AND (cancer)]. The primary outcomes assessed were HF hospitalization and new HF diagnoses. The search yielded 1880 studies, from which 13 studies encompassing 88 273 patients were included. SGLT2i use reduced HF hospitalizations by 51% (RR 0.49, 95% CI 0.36-0.66, I² = 28%, P ConclusionSGLT2i significantly lower the risk of HF hospitalization and new HF diagnoses among cancer patients and survivors, with particularly pronounced benefits in breast cancer patients receiving anthracycline-based chemotherapy. These findings support the need for prospective trials to further investigate the integration of SGLT2i into cancer patient management to enhance cardiovascular outcomes.

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Background: Type 2 diabetes mellitus (T2DM) is associated with subclinical myocardial dysfunction, which may occur despite preserved left ventricular ejection fraction. Left ventricular global longitudinal strain (LV GLS) is a sensitive marker of early systolic impairment and may detect subtle changes in myocardial function before conventional echocardiographic parameters become abnormal. The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on LV GLS in adults with T2DM remains incompletely defined. Objective: To synthesize the available evidence on the effects of SGLT2i therapy on LV GLS or LV strain in adults with T2DM. Methods: Original full-text human studies evaluating SGLT2i therapy in adults with T2DM and reporting LV GLS or LV strain were included. LV GLS was assessed primarily by speckle-tracking echocardiography, while one study used cardiac magnetic resonance feature-tracking. Reviews, conference abstracts, protocols, animal-only studies, and studies without LV strain assessment were excluded. Risk of bias was assessed using RoB 2 for randomized studies and ROBINS-I for non-randomized studies. Results: Twenty-six studies involving more than 2300 participants were included. The studies evaluated dapagliflozin, empagliflozin, ertugliflozin, canagliflozin, or mixed SGLT2i regimens across heterogeneous clinical populations, including patients with preserved ejection fraction, pre-heart failure, diabetes-related cardiomyopathy, chronic heart failure, coronary artery disease, hypertension, non-alcoholic fatty liver disease, and cardio-oncology risk. Most observational and before-after studies reported favorable changes in LV GLS after SGLT2i therapy, whereas randomized and controlled studies showed more variable findings. Several studies also reported improvements in LV remodeling, diastolic function, left atrial function, myocardial work indices, NT-proBNP, cardiometabolic parameters, or epicardial adipose tissue thickness. However, the certainty of evidence was limited by methodological heterogeneity, differences in comparator groups, variable follow-up duration, non-standardized imaging protocols, and risk of bias, particularly in non-randomized and single-arm studies. Conclusions: SGLT2i therapy may be associated with favorable changes in LV GLS in adults with T2DM, suggesting a potential beneficial effect on subclinical left ventricular systolic function. However, current evidence does not definitively establish a consistent treatment effect across all populations. Larger randomized controlled trials with standardized strain imaging protocols, predefined LV GLS endpoints, and clinically relevant follow-up are needed to determine whether SGLT2i-related improvements in LV GLS reflect true myocardial benefit and translate into improved cardiovascular outcomes.

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Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a transformative therapy in type 2 diabetes mellitus (T2DM), offering benefits that extend beyond glycemic control. We conducted a meta-analysis of six large randomized controlled trials (RCTs), enrolling more than 47,000 patients with T2DM and varying risks of cardiovascular disease (CVD) and chronic kidney disease (CKD), to evaluate the effect of SGLT2 inhibitors on hospitalization for heart failure (HHF). Across a mean follow-up ranging from 1.3 to 4.2 years, SGLT2 inhibitors were associated with a 28% relative risk reduction in HHF compared with placebo or standard care. This benefit was consistent across most agents, including empagliflozin, canagliflozin, dapagliflozin, and sotagliflozin, while ertugliflozin showed a nonsignificant trend in the same direction. Subgroup analyses confirmed benefits in patients with established atherosclerotic CVD as well as those with CKD, underscoring the broad applicability of this therapy. The results demonstrate that SGLT2 inhibitors confer clinically meaningful cardiorenal protection that is recognized to occur through mechanisms largely independent of glucose lowering, reinforcing their role as cornerstone agents in the management of T2DM. These findings highlight the importance of prioritizing SGLT2 inhibitors in contemporary diabetes care to reduce the global burden of heart failure (HF).

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Sodium-glucose cotransporter 2 (SGLT2) inhibitors were initially developed as glucose-lowering agents for type 2 diabetes mellitus (T2DM) by reducing proximal tubular glucose reabsorption and promoting glucosuria. Subsequent cardiovascular and renal outcome trials established that these agents provide clinically meaningful benefits that extend beyond glycemic control, including reductions in heart failure (HF) events and slowing of chronic kidney disease (CKD) progression in patients with and without diabetes. We conducted a narrative literature review using PubMed and Google Scholar to identify English-language studies published between January 2019 and December 2025 evaluating SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin, ertugliflozin) across cardiovascular and renal outcomes. Eligible evidence included randomized controlled trials, large observational studies, systematic reviews/meta-analyses, guidelines, post‑hoc exploratory analyses, secondary analyses, and mechanistic/preclinical studies. Mechanistic data support benefits through natriuresis and osmotic diuresis with favorable ventricular loading, restoration of tubuloglomerular feedback and reduced intraglomerular pressure, improved myocardial energetics, and attenuation of oxidative stress and inflammation. Clinically, SGLT2 inhibitors consistently reduce HF hospitalizations and composite cardiorenal endpoints in diabetic and non-diabetic populations across CKD stages studied and heart conditions, with a generally favorable safety profile; genital mycotic infections are most common, while diabetic ketoacidosis and volume depletion are uncommon with appropriate patient selection and counselling. Evidence gaps remain for stage 5 CKD and dialysis populations and for defining outcomes in lower-risk post-myocardial infarction cohorts. Overall, current data support SGLT2 inhibitors as foundational therapy for eligible patients with HF and/or CKD irrespective of diabetes status.

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