SGLT2 inhibitors improve survival over DPP4i in patients with cirrhosis and diabetes: Study

Patients with cirrhosis needing additional pharmacotherapy for diabetes beyond metformin experience increased survival with SGLT2i in relation to DPP4i. 

USA: SGLT2 inhibitors versus DPP4 inhibitors may improve survival in cirrhosis patients who require additional pharmacotherapy for diabetes beyond metformin, reveal results from a recent study in the journal Diabetes, Obesity and Metabolism.

Sodium-glucose cotransporter 2 inhibitors may have favorable metabolic and neurohumoral effects in chronic liver disease patients. However, studies examining SGLT2 inhibitors in this population are limited only to patients with non-alcoholic fatty liver disease (NAFLD) and have focused on surrogate biomarkers. Considering this, Saad Saffo, Yale School of Medicine, New Haven, Connecticut, and colleagues aimed to evaluate if SGLT2i can reduce the risk of death and ascites over a period of 36 months in patients with diabetes and cirrhosis. 

For this purpose, the researchers used electronic health data from Veterans Affairs hospitals in the United States. Following this, they conducted a propensity-score matched intention-to-treat analysis among veterans on metformin who subsequently received either SGLT2i or dipeptidyl peptidase-4 inhibitors (DPP4i).