Can SGLT2 Inhibitors Protect Our SLE Patients?

Conclusion

In this cohort of patients with SLE and DM2 who initiated SGLT2i or DPP4i, Jorge et al. found that SGLT2i use was associated with a lower risk of MACE and renal progression. Dr. Jorge concluded, “Our findings suggest a potential role for SGLT2i to improve outcomes in our SLE and LN patients. Further research is warranted. Next steps would include mechanistic studies of SGLT2i, as well as prospective studies and RCTs in patients with SLE and lupus nephritis, ideally without a separate indication of DM2, to confirm these findings.”

Samantha C. Shapiro, MD, is the executive editor of Harrison’s Principles of Internal Medicine. As a clinician educator, she practices telerheumatology and writes for both medical and lay audiences.

References

1. Jorge A, Zhou B, McCormick N, et al. Sodium-glucose co-transporter-2 inhibitors and the risk of cardiac and renal outcomes in systemic lupus erythematosus [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9).
2. Cowie MR, Fisher M. SGLT2 inhibitors: Mechanisms of cardiovascular benefit beyond glycaemic control. Nat Rev Cardiol. 2020 Dec;17(12):761–772.
3. Hernán MA, Wang W, Leaf DE. Target trial emulation: A framework for causal inference from observational data. JAMA. 2022;328(24):2446–2447.