SGLT2 Inhibitors Slow Risk of CVD Biomarker Levels in Diabetes Patients

Treatment with canagliflozin attenuated the rise in serum NT-proBNP and hsTnl for 2 years in older patients with type 2 diabetes, supporting the use of Sodium glucose co-transporter 2 inhibitors (SGLT2) inhibitors in diabetes patients, according to the results of a recent study.

Previous research has suggested that SGLT2 inhibitors could have beneficial cardiovascular effects in patients with diabetes. For their study, researchers randomly assigned 666 type 2 diabetes patients to either canagliflozin 100 or 300 mg, or to placebo. Primary outcomes included median percent change in serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI) soluable (s)ST2, and galectin-3 from baseline to 26, 52, and 104 weeks.
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Overall, serum NT-proBNP and serum hsTnI levels increased in placebo participants, but stayed relatively the same in individuals given canagliflozin. Hodges-Lehmann estimates of differences in median percent change between pooled canagliflozin and placebo were −15.0%, −16.1%, and −26.8% for NT-proBNP, and −8.3%, −11.9%, and −10.0% for hsTnI at weeks 26, 52, and 104, respectively.

Serum sST2 was unchanged over 104 weeks in both groups, and serum galectin-3 modestly increase in the canagliflozin group vs the placebo group.

“Compared with placebo, treatment with canagliflozin delayed the rise in serum NT-proBNP and hsTnI for over 2 years in older [type 2 diabetes mellitus] patients. These cardiac biomarker data provide support for the beneficial cardiovascular effect of sodium glucose co-transporter 2 inhibitors in [type 2 diabetes mellitus].”

—Michael Potts

Reference:

Januzzi JL, Butler J, Jarolim P, et al. Effects of canagliflozin on cardiovascular biomarkers in older adults with type 2 diabetes. JACC. 2017;70(6):704-712.