• Med Princ Pract · Jan 2022

    Meta Analysis

    Evaluating the Initiation of Sodium/Glucose Cotransporter 2 Inhibitors within Two Weeks of an Acute Hospital Admission: A Systematic Review and Meta-Analysis of Nine Clinical Trials.

    • Jenny Hui Ling Chieng, Tze Kai Sia, Yao Hao Teo, Joseph Zi An Wong, Tricia Jing Ying Ng, Yao Neng Teo, Nicholas L X Syn, Robin Cherian, Yoke-Ching Lim, Ping Chai, Weiqin Lin, Raymond C C Wong, and Ching-Hui Sia.
    • Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
    • Med Princ Pract. 2022 Jan 1; 31 (3): 215223215-223.

    ObjectiveRecent studies have increasingly shown the benefits of using sodium/glucose cotransporter 2 inhibitor (SGLT2i). However, there are concerns regarding the initiation of SGLT2i during acute hospital admissions due to the potential increased risk of complications. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of SGLT2i initiation within 2 weeks of an acute hospital admission.MethodsFour electronic databases (PubMed, Embase, Cochrane, and Scopus) were searched for articles published from inception up to 27 March 2021 that evaluated the efficacy and/or safety of SGLT2i initiation within 2 weeks of an acute hospital admission. Random-effects pair-wise meta-analysis models were utilized to summarize the studies. The protocol was registered with PROSPERO (CRD42021245492).ResultsNine clinical trials were included with a combined cohort of 1,758 patients. Patients receiving SGLT2i had a mean increase in 24-h urine volume of +487.55 mL (95% CI 126.86-848.25; p = 0.008) compared to those not started on SGLT2i. Patients with heart failure treated with SGLT2i had a 27% relative risk reduction in rehospitalizations for heart failure, compared to controls (risk ratio 0.73; p = 0.005). There were no differences in other efficacy and safety outcomes examined.ConclusionThere was no increased harm with initiation of SGLT2i within 2 weeks of an acute hospital admission, and its use reduced the relative risk of rehospitalizations for heart failure in patients with heart failure. It was also associated with increased urine output. However, current evidence pool is limited, especially in specific population subtypes.© 2022 The Author(s). Published by S. Karger AG, Basel.

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