Uso de los inhibidores del cotransportador sodio-glucosa tipo 2 para reducir complicaciones cardiológicas y renales en pacientes con diabetes tipo 2

Martin Alexander Chamorro Romero, Andrea Catalina Ochoa Bravo

Resumen


Una de las enfermedades más comunes en el mundo es la diabetes, específicamente la de tipo 2, la esta se produce fundamentalmente por la resistencia insulínica e hiperglucemia. Recientemente la inefectividad de la monoterapia con metformina en ciertos pacientes, resulta en la aparición de complicaciones, principalmente las de tipo cardiológico y renal, por lo que, se ha visto necesario implementar nuevas clases de antidiabéticos para lograr un manejo correcto en este tipo de pacientes. Investigaciones recientes han encontrado que el uso de los inhibidores del cotransportador sodio-glucosa tipo 2 en personas que padecen diabetes tipo 2 y con riesgo de complicaciones cardíacas o renales son favorables, ya que se ha visto que estos medicamentos reducen la posibilidad de sufrir eventos cardíacos, principalmente insuficiencia cardíaca, además, de impedir la progresión o desarrollo de enfermedad renal en etapa crónica o terminal, todo esto debido a sus propiedades hipoglucemiantes, antinflamatorias y metabólicas, que evitan la hiperfiltración a nivel glomerular y reducen los niveles de tensión arterial, logrando efectos positivos en la función cardiaca y renal de pacientes que padecen diabetes tipo 2.


Palabras clave


Cardiopatías; Enfermedades Renales; Diabetes Mellitus tipo 2; Inhibidores del cotransportador de sodio-glucosa 2; Hipoglucemiantes

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Referencias


Petersmann A, Müller-Wieland D, Müller UA, Landgraf R, Nauck M, Freckmann G, et al. Definition, Classification and Diagnosis of Diabetes Mellitus. Experimental and Clinical Endocrinology and Diabetes 2019;127(S 01):S1–7. https://doi.org/10.1055/a-1018-9078

Henning RJ. Type-2 diabetes mellitus and cardiovascular disease. Future Cardiol 2018;14(6):491–509. https://doi.org/10.2217/fca-2018-0045

Glovaci D, Fan W, Wong ND. Epidemiology of Diabetes Mellitus and Cardiovascular Disease. Curr Cardiol Rep 2019;21(4):1–8. https://doi.org/10.1007/s11886-019-1107-y

Henning RJ. Type-2 diabetes mellitus and cardiovascular disease. Future Cardiol 2018;14(6):491–509. https://pubmed.ncbi.nlm.nih.gov/30409037/

Cloete L. Diabetes mellitus: an overview of the types, symptoms, complications and management. Nurs Stand. 2022;37(1):61–6. https://pubmed.ncbi.nlm.nih.gov/34708622/

Demir S, Nawroth PP, Herzig S, Ekim Üstünel B. Emerging Targets in Type 2 Diabetes and Diabetic Complications. Adv Sci (Weinh) 2021;8(18). https://pubmed.ncbi.nlm.nih.gov/34319011/

Da Silva PN, Da Conceição RA, do Couto Maia R, De Castro Barbosa ML. Sodium–glucose cotransporter 2 (SGLT-2) inhibitors: a new antidiabetic drug class. Medchemcomm 2018;9(8):1273–81. https://doi.org/10.1039/C8MD00183A

Garcia-Ropero A, Badimon JJ, Santos-Gallego CG. The pharmacokinetics and pharmacodynamics of SGLT2 inhibitors for type 2 diabetes mellitus: the latest developments. Expert Opin Drug Metab Toxicol 2018;14(12):1287–302. https://doi.org/10.1080/17425255.2018.1551877

Ni L, Yuan C, Chen G, Chen G, Zhang C, Zhang C, et al. SGLT2i: Beyond the glucose-lowering effect. Cardiovasc Diabetol 2020;19(1):1–10. https://doi.org/10.1186/s12933-020-01071-y

Kelly MS, Lewis J, Huntsberry AM, Dea L, Portillo I. Efficacy and renal outcomes of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease. Postgrad Med 2018;131(1):31–42. https://doi.org/10.1080/00325481.2019.1549459

Ninčević V, Kolarić TO, Roguljić H, Kizivat T, Smolić M, Ćurčić IB. Renal Benefits of SGLT 2 Inhibitors and GLP-1 Receptor Agonists: Evidence Supporting a Paradigm Shift in the Medical Management of Type 2 Diabetes. International Journal of Molecular Sciences 2019;20(23):5831. https://doi.org/10.3390/ijms20235831

Santos-Ferreira D, Gonçalves-Teixeira P, Fontes-Carvalho R. SGLT-2 Inhibitors in Heart Failure and Type-2 Diabetes: Hitting Two Birds with One Stone?. Cardiology 2020;145(5):311–20. https://doi.org/10.1159/000504694

Tilinca MC, Tiuca RA, Tilea I, Varga A. The sglt-2 inhibitors in personalized therapy of diabetes mellitus patients. J Pers Med 2021;11(12):1249. https://doi.org/10.3390/jpm11121249

Xu B, Li S, Kang B, Zhou J. The current role of sodium-glucose cotransporter 2 inhibitors in type 2 diabetes mellitus management. Cardiovascular Diabetology 2022;21(1):1–21. https://doi.org/10.1186/s12933-022-01512-w

Gu N, Park SI, Chung H, Jin X, Lee S, Kim TE. Possibility of pharmacokinetic drug interaction between a DPP-4 inhibitor and a SGLT2 inhibitor. Transl Clin Pharmacol 2020;28(1):17–33. https://doi.org/10.12793/tcp.2020.28.e4

Avogaro A, Delgado E, Lingvay I. When metformin is not enough: Pros and cons of SGLT2 and DPP-4 inhibitors as a second line therapy. Diabetes Metab Res Rev 2018;34(4):e2981. https://doi.org/10.1002/dmrr.2981

Ji L, Liu Y, Miao H, Xie Y, Yang M, Wang W, et al. Safety and efficacy of ertugliflozin in Asian patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: VERTIS Asia. Diabetes Obes Metab 2019;21(6):1474–82. https://doi.org/10.1111/dom.13681

Xie Y, Bowe B, Gibson AK, McGill JB, Maddukuri G, Yan Y, et al. Comparative Effectiveness of SGLT2 Inhibitors, GLP-1 Receptor Agonists, DPP-4 Inhibitors, and Sulfonylureas on Risk of Kidney Outcomes: Emulation of a Target Trial Using Health Care Databases. Diabetes Care 2020;43(11):2859–69. https://doi.org/10.2337/dc20-1890

van Ruiten CC, van der Aart-van der Beek AB, IJzerman RG, Nieuwdorp M, Hoogenberg K, van Raalte DH, et al. Effect of exenatide twice daily and dapagliflozin, alone and in combination, on markers of kidney function in obese patients with type 2 diabetes: A prespecified secondary analysis of a randomized controlled clinical trial. Diabetes Obes Metab 2021;23(8):1851–8. https://doi.org/10.1111/dom.14410

Hiruma S, Shigiyama F, Hisatake S, Mizumura S, Shiraga N, Hori M, et al. A prospective randomized study comparing effects of empagliflozin to sitagliptin on cardiac fat accumulation, cardiac function, and cardiac metabolism in patients with early-stage type 2 diabetes: the ASSET study. Cardiovasc Diabetol 2021;20(1):1–13. https://doi.org/10.1186/s12933-021-01228-3

Williams DM, Evans M. Are SGLT-2 Inhibitors the Future of Heart Failure Treatment? The EMPEROR-Preserved and EMPEROR-Reduced Trials. Diabetes Therapy 2020;11(9):1925–34. https://doi.org/10.1007/s13300-020-00889-9

Chen S, Coronel R, Hollmann MW, Weber NC, Zuurbier CJ. Direct cardiac effects of SGLT2 inhibitors. Cardiovasc Diabetol 2022;21(1):1–13. https://doi.org/10.1186/s12933-022-01480-1

Zelniker TA, Raz I, Mosenzon O, Dwyer JP, Heerspink HHJL, Cahn A, et al. Effect of Dapagliflozin on Cardiovascular Outcomes According to Baseline Kidney Function and Albuminuria Status in Patients With Type 2 Diabetes: A Prespecified Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol 2021;6(7):801–10. https://pubmed.ncbi.nlm.nih.gov/33851953/

Böhm M, Slawik J, Brueckmann M, Mattheus M, George JT, Ofstad AP, et al. Efficacy of empagliflozin on heart failure and renal outcomes in patients with atrial fibrillation: data from the EMPA-REG OUTCOME trial. Eur J Heart Fail 2020;22(1):126–35. https://doi.org/10.1002/ejhf.1663

Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. New England Journal of Medicine 2019;380(24):2295–306. https://www.nejm.org/doi/10.1056/NEJMoa1811744

Furtado RHM, Raz I, Goodrich EL, Murphy SA, Bhatt DL, Leiter LA, et al. Efficacy and Safety of Dapagliflozin in Type 2 Diabetes According to Baseline Blood Pressure: Observations from DECLARE-TIMI 58 Trial. Circulation 2022;145(21):1581–91. https://doi.org/10.1161/CIRCULATIONAHA.121.058103

Perkovic V, de Zeeuw D, Mahaffey KW, Fulcher G, Erondu N, Shaw W, et al. Canagliflozin and renal outcomes in type 2 diabetes: results from the CANVAS Program randomised clinical trials. Lancet Diabetes Endocrinol 2018;6(9):691–704. https://doi.org/10.1016/S2213-8587(18)30141-4

Salah HM, Al’Aref SJ, Khan MS, Al-Hawwas M, Vallurupalli S, Mehta JL, et al. Efficacy and safety of sodium-glucose cotransporter 2 inhibitors initiation in patients with acute heart failure, with and without type 2 diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol 2022;21(1):1–8. https://doi.org/10.1186/s12933-022-01455-2

Kaze AD, Zhuo M, Kim SC, Patorno E, Paik JM. Association of SGLT2 inhibitors with cardiovascular, kidney, and safety outcomes among patients with diabetic kidney disease: a meta-analysis. Cardiovasc Diabetol 2022;21(1):1–14. https://doi.org/10.1186/s12933-022-01476-x

Singh JSS, Mordi IR, Vickneson K, Fathi A, Donnan PT, Mohan M, et al. Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial. Diabetes Care 2020;43(6):1356–9. https://doi.org/10.2337/dc19-2187

Lingvay I, Greenberg M, Gallo S, Shi H, Liu J, Gantz I. Efficacy and safety of ertugliflozin in patients with type 2 diabetes mellitus and established cardiovascular disease using insulin: A VERTIS CV substudy. Diabetes Obes Metab 2021;23(7):1640–51. https://doi.org/10.1111/dom.14385

Perry RJ, Shulman GI. Sodium-glucose cotransporter-2 inhibitors: Understanding the mechanisms for therapeutic promise and persisting risks. Journal of Biological Chemistry 2020;295(42):14379–90. https://doi.org/10.1074/jbc.REV120.008387

Tomasoni D, Fonarow GC, Adamo M, Anker SD, Butler J, Coats AJS, et al. Sodium–glucose co-transporter 2 inhibitors as an early, first-line therapy in patients with heart failure and reduced ejection fraction. Eur J Heart Fail 2022;24(3):431–41. https://doi.org/10.1002/ejhf.2397

Lee MMY, Brooksbank KJM, Wetherall K, Mangion K, Roditi G, Campbell RT, et al. Effect of Empagliflozin on Left Ventricular Volumes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure With Reduced Ejection Fraction (SUGAR-DM-HF). Circulation 2021;143(6):516–25. https://doi.org/10.1161/CIRCULATIONAHA.120.052186

Kim SR, Lee SG, Kim SH, Kim JH, Choi E, Cho W, et al. SGLT2 inhibition modulates NLRP3 inflammasome activity via ketones and insulin in diabetes with cardiovascular disease. Nat Commun 2020;11(1). https://doi.org/10.1038/s41467-020-15983-6

Prattichizzo F, de Candia P, Ceriello A. Diabetes and kidney disease: emphasis on treatment with SGLT-2 inhibitors and GLP-1 receptor agonists. Metabolism 2021;120. https://doi.org/10.1016/j.metabol.2021.154799

Tentolouris A, Vlachakis P, Tzeravini E, Eleftheriadou I, Tentolouris N. SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects. International Journal of Environmental Research and Public Health 2019;16(16):2965. https://doi.org/10.3390/ijerph16162965

Skrabic R, Kumric M, Vrdoljak J, Rusic D, Skrabic I, Vilovic M, et al. SGLT2 Inhibitors in Chronic Kidney Disease: From Mechanisms to Clinical Practice. Biomedicines 2022;10(10):2458. https://doi.org/10.3390/biomedicines10102458

Scholtes RA, van Baar MJB, Kok MD, Bjornstad P, Cherney DZI, Joles JA, et al. Renal haemodynamic and protective effects of renoactive drugs in type 2 diabetes: Interaction with SGLT2 inhibitors. Nephrology 2021;26(5):377–90. https://doi.org/10.1111/nep.13839

Nespoux J, Vallon V. SGLT2 inhibition and kidney protection. Clin Sci 2018;132(12):1329–39. https://doi.org/10.1042/CS20171298

Heerspink HJL, Stefánsson B V., Correa-Rotter R, Chertow GM, Greene T, Hou FF, et al. Dapagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine 2020;383(15):1436–46. https://www.nejm.org/doi/full/10.1056/NEJMoa2024816

Herrington W, Staplin N, Wanner C, Green J, Hauske S, Emberson J, et al. Empagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine 2023;388(2):117–27. https://www.nejm.org/doi/full/10.1056/NEJMoa2204233

Lo KB, Gul F, Ram P, Kluger AY, Tecson KM, McCullough PA, et al. The Effects of SGLT2 Inhibitors on Cardiovascular and Renal Outcomes in Diabetic Patients: A Systematic Review and Meta-Analysis. Cardiorenal Med 2020;10(1):1–10. https://doi.org/10.1159/000503919

Seidu S, Kunutsor SK, Topsever P, Khunti K. Benefits and harms of sodium-glucose co-transporter-2 inhibitors (SGLT2-I) and renin–angiotensin–aldosterone system inhibitors (RAAS-I) versus SGLT2-Is alone in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Endocrinol Diabetes Metab 2022;5(1):e00303. https://doi.org/10.1002/edm2.303

Park G, Choi B, Kang S, Kim B, Chang MJ. Sodium–Glucose Cotransporter-2 Inhibitors Could Help Delay Renal Impairment in Patients with Type 2 Diabetes: A Real-World Clinical Setting. J Clin Med 2022;11(18):5259. https://doi.org/10.3390/jcm11185259




DOI: https://doi.org/10.23857/pc.v8i6.5686

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