Sotagliflozin’s Effect on BP Remains in T2D Regardless of Kidney Function | AHA 2024

The dual sodium-glucose cotransporter (SGLT) inhibitor sotagliflozin’s impact on systolic blood pressure is maintained in patients with type 2 diabetes (T2D) regardless of kidney function, according to research presented at the American Heart Association’s 2024 Scientific Sessions, held November 16 to 18 in Chicago, Illinois.¹ The authors said the findings indicate that sotagliflozin could be a new therapeutic option for patients with diabetes.

Sotagliflozin’s Effect on BP Remains in T2D Regardless of Kidney Function | AHA 2024 / neirfy - stock.adobe.com

SGLT-2 inhibitors are approved for use in patients with T2D alongside diet and exercise to lower blood sugar. Research has shown that this class of medications improve glycemic control, reduce major adverse cardiovascular events, and decrease the risk of cardiovascular hospitalizations and deaths.² Although sotagliflozin, which is an SGLT-2 inhibitor that also provides some SGLT-1 inhibition, has notable glycemic benefits, they are reduced due to declining kidney function.

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Investigators from Emory University School Medicine and Lexicon Pharmaceuticals conducted a study to determine the effect of sotagliflozin on systolic blood pressure across a broad range of patients including those with moderate to severe renal impairment. Data for the study was gathered from 3 clinical trials: inTandem (NCT02384941), SOLOIST-WHF (NCT03521934) and SCORED (NCT03315143).

The study cohort included 3896 patients with a mean age of 63 years, a mean BMI of 32 kg/m2, a mean systolic blood pressure of 133 mmHg, and a mean estimated glomerular filtration rate (eGFR) of 74 mL/min/1.73m2. Patients were treated with either once-daily sotagliflozin 400 mg, 200 mg or placebo.

The study found that of the patients, 2207 had a systolic blood pressure of equal to or greater than 130 mmHg and 1120 had a systolic blood pressure of equal or greater to 140 mmHg at baseline. Of those patients, 81% were using antihypertensive medications and 271 had an eGFR of less than 30, 1046 had an eGFR of less than 60, and 2557 had an eGFR of equal to or greater than 60.

At 26 weeks, both 200mg and 400mg sotagliflozin significantly reduced systolic blood pressure in all patients compared to placebo. The mean difference was -3.5% and -3.4%, respectively. IN patients with systolic blood pressure of equal to or greater than 130 mmHg, the difference was -2.6% and -3.7%, followed by -2.5% and -3.6% in patients with a systolic blood pressure of equal or greater to 140 mmHg. Additionally, the reductions in systolic blood pressure were regardless of baseline eGFR.

“Despite the known attenuation of glycemic control with SGLT inhibitors with declining kidney function, the effects of sotagliflozin on systolic blood pressure are maintained in patients with T2D regardless of kidney function,” the authors concluded. “Together with improvements in other cardiometabolic parameters shown in both patients with T1D and T2D, sotagliflozin may offer a new therapeutic option for patients with diabetes.”

READ MORE: Diabetes Resource Center

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References

1. Hardin M, Davies MJ, Carroll A, et al. Effect of Sotagliflozin, a Dual SGLT1 and SGLT2 Inhibitor, on Systolic Blood Pressure in Patients with Type 2 Diabetes. Presented at: American Heart Association’s 2024 Scientific Sessions; November 16-18, 2024; Chicago, IL. Poster Su3019.

2. Padda IS, Mahtani AU, Parmar M. Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors. [Updated 2023 Jun 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576405/