SGLT-2 inhibitors improve exercise capacity and QoL in patients with chronic HF

China: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors improve health-related quality of life (HRQoL) and exercise capacity in chronic heart failure (HF) patients, a recent study has shown. SGLT-2 inhibitors did not affect volume depletion.

The findings from the study appeared in the International Journal of Clinical Pharmacy on 17 February 2023.

Heart failure impairs quality of life (QoL). Despite successful therapies that improve mortality and morbidity, most heart failure patients have troublesome symptoms. Improving health-related quality of life and exercise capacity is essential for treating heart failure.

SGLT-2 inhibitor is a new class of oral glucose-lowering agents that reduce serum glucose and lower blood pressure by promoting glucosuria. Some studies have shown that other than increasing the excretion of glucosuria in type 2 diabetes patients, SGLT-2 inhibitors can notably improve cardiovascular outcomes, including the incidence of hospitalization for heart failure and cardiovascular death. There is a requirement for systematic analysis of the evidence of SGLT-2 inhibitors on exercise capacity and HRQoL in patients with chronic heart failure.

Considering this, Lingjiao Wang and colleagues from China aimed to summarize the SGLT-2 inhibitors' effect on exercise capacity, HRQoL, and volume depletion in patients with HF in a meta-analysis.

For this purpose, the researchers searched online databases for randomized controlled trials. The intervention arm comprised the SGLT-2 inhibitor group, and the control group formed the placebo group. HRQoL outcomes included the KCCQ (Kansas City Cardiomyopathy Questionnaires)-OSS (Overall Summary Score), KCCQ-TSS (Total Symptom Score) and the KCCQ-CSS (Clinical Summary Score). Exercise capacity was determined with a 6-min walk test distance (6MWTD). The last search was on May 2022. Two researchers did the screening, data extraction, and evaluation of the quality of included trials independently. The quality of each study was examined using the Cochrane risk-of-bias tool.

Eight studies comprising 6,213 patients were included.

The study led to the following findings:

SGLT-2 inhibitors, compared to the placebo group, significantly improved HRQoL parameters of the KCCQ-OSS score [mean difference (MD) 4.00] and KCCQ-CSS score [MD 5.17] and

The authors observed a significant improvement in exercise capacity 6MWTD (MD 21.90) with SGLT-2 inhibitors.

There were no remarkable differences in KCCQ-TSS (MD 1.95) and volume depletion [odds ratio (OR) 1.15] between the treatment and placebo groups.

"In patients with chronic HF, SGLT-2 inhibitors could improve exercise capacity and HRQoL," the researchers wrote. "SGLT-2 inhibitors did not affect the volume depletion."

Reference:

Wang, L., Yu, J., Guo, Z. et al. The role of SGLT-2 inhibitors on health-related quality of life, exercise capacity, and volume depletion in patients with chronic heart failure: a meta-analysis of randomized controlled trials. Int J Clin Pharm (2023). https://doi.org/10.1007/s11096-022-01504-6