Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti, 14, 10126, Turin, Italy.
Hormones (Athens). 2023 Jun;22(2):343-347. doi: 10.1007/s42000-023-00430-0. Epub 2023 Jan 19.
SLGT-2 inhibitors have recently been investigated as a promising therapy for syndrome of inappropriate antidiuresis (SIAD). However, to our knowledge, no report has been published about their use for this indication in the long term.
We report the case of a 68-year-old male with type 2 diabetes and chronic SIAD, in whom serum sodium levels were not adequately controlled by urea monotherapy. Other treatment options were not viable due to inefficacy or adverse effects. The initiation of empagliflozin, in addition to urea, led to the full normalization of serum sodium. Reduction and subsequent discontinuation of urea were attempted upon patient request, but this resulted in a relapse of hyponatremia. Nevertheless, stable normonatremia was again achieved and maintained for more than 6 months after re-establishing a combination therapy with empagliflozin and urea.
SGLT2 inhibitors might represent an effective treatment for SIAD, even in the long term. Specific clinical trials are needed to confirm this result.
最近，SLGT-2 抑制剂已被研究作为治疗抗利尿激素不适当分泌综合征（SIAD）的一种有前途的疗法。然而，据我们所知，尚无关于它们在该适应证中长期使用的报告。
我们报告了一例 68 岁男性，患有 2 型糖尿病和慢性 SIAD，单用尿素治疗未能充分控制血清钠水平。由于无效或不良反应，其他治疗选择不可行。加用恩格列净治疗除了尿素外，还导致血清钠完全正常化。根据患者的要求尝试减少并随后停用尿素，但这导致低钠血症复发。然而，在重新建立恩格列净和尿素联合治疗后，再次实现并维持稳定的正常血钠水平超过 6 个月。
SGLT2 抑制剂可能是治疗 SIAD 的有效方法，甚至可以长期使用。需要进行专门的临床试验来证实这一结果。
