Inhibitors of the sodium-glucose cotransporter 2 (SGLT2) are dramatically changing the management of heart failure and, especially, chronic kidney disease. Indeed, this class of drugs, which was initially developed to improve glycemia control in Type 2 diabetics, is now widely recommended by global/international guidelines as part of the standard care for both diabetics and non-diabetics presenting with heart failure and/or albuminuric chronic kidney disease. Indeed, large outcome trials have conclusively demonstrated their efficacy and safety, with some undesirable effects that are easily manageable in clinical practice, such as mycotic genital infection. The key challenge for the coming years is to ensure that the broad population of patients susceptible to benefit from SGLT2-i is actually treated by these drugs. In the near future, additional trials may further enlarge the population targeted by this drug class.
Key words
SGLT2-inhibitor, chronic kidney disease, heart failure, randomized controlled trial, nephroprotection, cardiovascular disease, KDIGO guidelines, diabetes type 2