In patients with type 2 diabetes mellitus (T2DM), the main cause of morbidity and mortality is cardiovascular (CV) disease. Diabetic kidney disease, which develops in approximately 40% of patients with T2DM, further increases the risk of CV-related morbidity and mortality. The sodium glucose co-transporter 2 (SGLT2) inhibitor empagliflozin, which provides effective glycaemic control as either monotherapy or as an add-on to other glucose-lowering agents in patients with T2DM, was also shown to improve CV and renal outcomes in the large, randomised, placebo-controlled EMPA-REG OUTCOME trial in patients with T2DM at high risk of CV events. The underlying mechanisms for the CV and renal protective effects of empagliflozin are not fully understood, but are likely to involve a combination of several mechanisms, including empagliflozin-associated body weight and blood pressure reductions, diuresis, a shift in substrate utilisation and activation of tubuloglomerular feedback. The results of ongoing CV outcomes trials with other SGLT2 inhibitors will potentially confirm whether the beneficial CV and renal effects observed in EMPA-REG OUTCOME are unique to empagliflozin or are a drug class effect.
Mechanisms linking empagliflozin to cardiovascular and renal protection / Perrone-Filardi, P; Avogaro, A; Bonora, E; Colivicchi, F; Fioretto, P; Maggioni, Ap; Sesti, G; Ferrannini, E. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 241:(2017), pp. 450-456. [0.1016/j.ijcard.2017.03.089]
Mechanisms linking empagliflozin to cardiovascular and renal protection
Sesti G;
2017
Abstract
In patients with type 2 diabetes mellitus (T2DM), the main cause of morbidity and mortality is cardiovascular (CV) disease. Diabetic kidney disease, which develops in approximately 40% of patients with T2DM, further increases the risk of CV-related morbidity and mortality. The sodium glucose co-transporter 2 (SGLT2) inhibitor empagliflozin, which provides effective glycaemic control as either monotherapy or as an add-on to other glucose-lowering agents in patients with T2DM, was also shown to improve CV and renal outcomes in the large, randomised, placebo-controlled EMPA-REG OUTCOME trial in patients with T2DM at high risk of CV events. The underlying mechanisms for the CV and renal protective effects of empagliflozin are not fully understood, but are likely to involve a combination of several mechanisms, including empagliflozin-associated body weight and blood pressure reductions, diuresis, a shift in substrate utilisation and activation of tubuloglomerular feedback. The results of ongoing CV outcomes trials with other SGLT2 inhibitors will potentially confirm whether the beneficial CV and renal effects observed in EMPA-REG OUTCOME are unique to empagliflozin or are a drug class effect.File | Dimensione | Formato | |
---|---|---|---|
Perrone-Filardi_Mechanisms_2017.pdf
solo gestori archivio
Tipologia:
Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza:
Tutti i diritti riservati (All rights reserved)
Dimensione
615.59 kB
Formato
Adobe PDF
|
615.59 kB | Adobe PDF | Contatta l'autore |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.