Bexagliflozin on Renal Outcomes in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are important for treating type 2 diabetes mellitus (T2DM). However, it remains unclear whether the newest SGLT2 inhibitor, bexagliflozin, provides benefits for renal- or urinary-related outcomes. The ClinicalTrials.gov, PubMed, Embase, and Cochrane databases were searched for randomized controlled trials. Using R software version 4.3.1 (R Foundation for Statistical Computing, Vienna, Austria), a random-effects model was employed to compute mean differences (MD) and risk ratios for continuous and binary endpoints. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence. The International Prospective Register of Systematic Reviews (PROSPERO) identification number is CRD42023478336. Nine studies involving 4,352 patients were included. Over a follow-up that ranged from 12 to 96 weeks, patients taking bexagliflozin showed no changes in serum creatinine levels (MD: 0.05 mg/dL; 95% CI: -0.06 to 0.15; p = 0.35) or estimated glomerular filtration rate (MD: -0.43 mL/min/1.73 m; 95% CI: -6.92 to 6.06; p = 0.89). However, there was a significant reduction in systolic blood pressure in the treatment group (MD: -4.2 mmHg; 95% CI: -5.6 to -2.8; p < 0.01). In large placebo-controlled trials, we observed no beneficial effect of bexagliflozin on kidney function, as described with other SGLT2 inhibitors.