Sotagliflozin, a recently-US Food and Drug Administration (FDA) approved drug for the treatment of type 2 diabetes and kidney disease with additional cardiovascular risk factors, can significantly reduce heart attack and stroke among these patients, according to results of an international clinical trial published in The Lancet Diabetes & Endocrinology.
Sotagliflozin is a sodium-glucose cotransporter (SGLT) inhibitor. It blocks the function of two proteins—SGLT1 and SGLT2—which move glucose and sodium across cell membranes and help control blood sugar levels. Other SGLT2 inhibitors do not as significantly block SGLT1.
The study is the first to show that an SGLT inhibitor has these unique cardiovascular benefits. The results mean that sotagliflozin could become more widely used to reduce the risk of deadly cardiovascular events globally.
“These results demonstrate a new mechanism of action—combined blockade with sotagliflozin of the SGLT1 receptors (found in the kidney, gut, heart, and brain) and SGLT2 receptors (found in the kidney)—to reduce heart attack and stroke risk,” says study chair Deepak L Bhatt (Icahn School of Medicine at Mount Sinai, New York, USA). “The benefits seen here are distinct from those seen with the other very popular SGLT2 inhibitors in widespread clinical use for diabetes, heart failure, and kidney disease.”
The randomised, multicenter trial, known as SCORED, analysed the ability of sotagliflozin to reduce the risks of life-threatening cardiovascular outcomes. Researchers enrolled 10,584 patients with chronic kidney disease, type 2 diabetes, and additional cardiovascular risk factors; randomly assigned them to sotagliflozin or placebo; and followed them for an average of 16 months. Patients in the sotagliflozin group had a 23% reduction in the rate of heart attacks, strokes, and deaths from such cardiovascular causes compared with the placebo group.
“Physicians now have a new option to reduce global cardiovascular risk such as heart failure, progression of kidney disease, heart attack, and stroke in patients with either heart failure or type 2 diabetes, chronic kidney disease, and other cardiovascular risk factors,” adds Bhatt. “This drug was approved to reduce the risk of deaths from cardiovascular causes, hospitalisations for heart failure, and urgent heart failure visits for patients with either heart failure or type 2 diabetes, chronic kidney disease, and other cardiovascular risk factors. These important, new data show that it additionally reduces the risk of heart attacks and strokes, and we could see more widespread use as a result.”
