Empagliflozin promising in hyponatremia induced by Chronic Syndrome of Inappropriate Antidiuresis

The study's findings are published in the Journal of the American Society of Nephrology.

SIAD leads to hypotonic hyponatremia and is challenging to treat. The therapeutic modalities available remain limited, and there needs to be more data on their association with neurocognitive impairment.

There is a requirement for newer management options. SGLT2 inhibitor empagliflozin could be valuable in promoting osmotic diuresis by urinary glucose excretion.

Considering this, researchers investigated this background to investigate whether four weeks of empagliflozin treatment increases serum sodium levels and improves neurocognition.

This RCT trial with 14 participants revealed well toleration of empagliflozin with improvement.

The study points include the following:

• There were 14 patients with SIAD aged 72 years who were predominantly females.
• The comparison was made for 4-week empagliflozin 25 mg/day to placebo.
• At baseline, the median serum sodium level was 131 mmol/L which rose to 134 mmol/L after treatment with empagliflozin.
• In the placebo, there no improvement was seen.
• Empagliflozin treatment improved neurocognition with an increase of 1.16 in the MoCA score.

The researchers reported no side effects. They wrote empagliflozin is a cost-effective treatment option Considering its cardiovascular and renal benefits.

It is beneficial in chronic hyponatremia with a high burden of comorbidities.

The study's strength includes study design and novelty approach whereas limitation include small sample size and possible power issue for detecting test performance difference.

References:

Refardt, Julie1,2; Imber, Cornelia1,2; Nobbenhuis, Rianne1,2; Sailer, Clara O.1,2; Haslbauer, Aaron3; Monnerat, Sophie1,2; Bathelt, Cemile1,2; Vogt, Deborah R.2; Berres, Manfred4; Winzeler, Bettina1,2; Bridenbaugh, Stephanie A.3; Christ-Crain, Mirjam1,2. Treatment Effect of the SGLT2 Inhibitor Empagliflozin on Chronic Syndrome of Inappropriate Antidiuresis: Results of a Randomized, Double-Blind, Placebo-Controlled, Crossover Trial. Journal of the American Society of Nephrology 34(2):p 322-332, February 2023. | DOI: 10.1681/ASN.2022050623