Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Curr Probl Cardiol. 2022 Oct;47(10):100995. doi: 10.1016/j.cpcardiol.2021.100995. Epub 2021 Sep 24.
Sodium glucose cotransporter-2 (SGLT2) inhibitors and loop diuretics can cause volume depletion. However, the long-term safety of the concurrent use of both agents has not been widely evaluated. We conducted a retrospective observational cohort study to evaluate the safety of SGLT2 inhibitors with loop diuretics vs SGLT2 inhibitors alone among diabetic patients. The primary endpoint was a composite of volume-depletion adverse events at 1 month and 12 months. Of the 400 patients included, 98 received SGLT2 inhibitors with a loop diuretic and 302 received SGLT2 inhibitors alone. The concurrent use of SGLT2 inhibitors and loop diuretics was tolerated at 1 month; however, it resulted in a significant increase in volume-depletion events at 12 months (10.2% vs 1.7%; aHR = 7.03, 95% CI (1.80-27.37), P-value = 0.005). In conclusion, the long-term concurrent use of SGLT2 inhibitors and loop diuretics increases the risk of volume depletion, warranting frequent monitoring.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂和袢利尿剂可导致血容量不足。然而，这两种药物同时使用的长期安全性尚未得到广泛评估。我们进行了一项回顾性观察性队列研究，以评估糖尿病患者同时使用 SGLT2 抑制剂和袢利尿剂与单独使用 SGLT2 抑制剂的安全性。主要终点是 1 个月和 12 个月时容量不足不良事件的综合指标。在 400 名患者中，98 名接受 SGLT2 抑制剂联合袢利尿剂治疗，302 名接受 SGLT2 抑制剂单独治疗。SGLT2 抑制剂与袢利尿剂同时使用在 1 个月时可耐受，但在 12 个月时导致容量不足事件显著增加（10.2%比 1.7%；aHR=7.03，95%CI（1.80-27.37），P 值=0.005）。总之，长期同时使用 SGLT2 抑制剂和袢利尿剂会增加容量不足的风险，需要密切监测。
