SGLT2 inhibitors may decrease risk of cardiac events in patients treated with anthracyclines

USA: A new study published in the Journal of American College of Cardiology suggests that sodium-glucose co-transporter-2 (SGLT2) inhibitors were related to a decreased risk of cardiac events in individuals with cancer and diabetes who were treated with anthracyclines. Also, SGLT2 inhibitors appeared to be safe. 

Patients with documented heart failure benefit from SGLT2 inhibitors. Despite encouraging fundamental science research, there is no data on the efficacy of SGLT2 inhibitors in anthracycline-treated patients. As a result, Carlos A. Gongora and colleagues undertook this research to assess the cardiac effectiveness and overall safety of SGLT2 inhibitors in anthracycline-treated patients.

This research included 3,033 individuals with diabetes and cancer who had been treated with anthracyclines. Patients with cancer and diabetes who were on anthracyclines were included in the study (n = 32). Patients with cancer and diabetes who were also on anthracyclines but not taking an SGLT2 inhibitor were included in the control group (n = 96). The primary cardiac outcome was a combination of cardiac events (heart failure incidence, heart failure hospitalizations, new cardiomyopathy (>10% decrease in ejection fraction to 53%), and clinically severe arrhythmias). Overall mortality was the key safety result.

The key findings of this study were as follows:

1. Age, gender, ethnicity, cancer stage, cancer type, and other cardiovascular risk variables were comparable among groups.

2. There were 20 cardiac incidents throughout a 1.5-year median follow-up period.

3. The incidence of cardiac events was lower in case patients compared to control individuals (3% versus 20%).

4. When compared to control participants, case patients had lower overall mortality (9% vs 43%) and a lower aggregate of sepsis and neutropenic fever (16% vs 40%).

In conclusion, the findings of this study show that SGLT2 inhibitors are safe to use. These results justify the conduct of a randomized clinical study investigating SGLT2 inhibitors in anthracycline-treated individuals with significant cardiac risk.

Reference:

Gongora, C. A., Drobni, Z. D., Quinaglia Araujo Costa Silva, T., Zafar, A., Gong, J., Zlotoff, D. A., Gilman, H. K., Hartmann, S. E., Sama, S., Nikolaidou, S., Suero-Abreu, E., Barnes, J., Armand, P., Thavendiranathan, P., Nohria, A., & Neilan, T. G. (2022). Sodium-glucose co-transporter-2 inhibitors and cardiac outcomes among patients treated with anthracyclines. JACC. Heart Failure. https://doi.org/10.1016/j.jchf.2022.03.006