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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
Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751