Cardiovascular benefits related to the use of SGLT-2 protein inhibitor drugs
DOI:
https://doi.org/10.33448/rsd-v13i3.45349Keywords:
Diabetes Mellitus; Heart failure; SGLT-2.Abstract
Sodium and glucose co-transporters (SGLT) are proteins that act by transferring sodium into cells, particularly with glucose, so that subtype 2 (SGLT-2) can reabsorb filtered glucose. In 2019, the American Diabetes Association recommended the use of SLGT-2 inhibitor drugs in patients with atherosclerotic cardiovascular disease at risk of heart failure. These medications alleviate heart injuries, thereby reducing deaths, nonfatal myocardial infarction, stroke, and hospitalizations for heart failure. This study will seek to discuss the cardiovascular benefits obtained from the use of these medications. This is a systematic review of the literature based on the guiding question: “What cardiovascular benefits can be obtained with the use of drugs that inhibit the SGLT-2 protein?” with a bibliographic survey carried out in the PUBMED database. The Controlled Health Sciences Descriptors (DeCS) used were: Sglt2; Cardiac insufficiency. Thus, 40 clinical trials published between 2017 and 2023 were selected according to the objective of the research and which met the inclusion criteria: articles published in English, Portuguese or Spanish, whose titles and abstracts were shown to be in accordance with the purpose. of the literature review, indexed in the aforementioned database. Repeated articles, theses, dissertations and analysis summaries were excluded. An analysis highlighted the benefits of SGLT-2 inhibitor drugs: improvements in energy pathways, antifibrotic effects and improved quality of life. In the stages, a reduction in hospitalizations, mortality and an increase in life expectancy were observed.
References
Agarwal, R., Anker, S. D., Filippatos, G., Pitt, B., Rossing, P., Ruilope, L. M., Boletis, J., Toto, R., Umpierrez, G. E., Wanner, C., Wada, T., Scott, C., Joseph, A., Ogbaa, I., Roberts, L., Scheerer, M. F., & Bakris, G. L. (2021). Effects of canagliflozin versus finerenone on cardiorenal outcomes: exploratory post hoc analyses from FIDELIO-DKD compared to reported CREDENCE results. Nephrology Dialysis Transplantation. https://doi.org/10.1093/ndt/gfab336
Berg, D. D., Jhund, P. S., Docherty, K. F., Murphy, S. A., Verma, S., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Langkilde, A. M., Martinez, F. A., Bengtsson, O., Ponikowski, P., Sjöstrand, M., Solomon, S. D., McMurray, J. J. V., & Sabatine, M. S. (2021). Time to Clinical Benefit of Dapagliflozin and Significance of Prior Heart Failure Hospitalization in Patients With Heart Failure With Reduced Ejection Fraction. JAMA Cardiology, 6(5), 499. https://doi.org/10.1001/jamacardio.2020.7585
Butt, J. H., Docherty, K. F., Jhund, P. S., Boer, R. A., Böhm, M., Desai, A. S., Howlett, J. G., Inzucchi, S. E., Kosiborod, M. N., Martinez, F. A., Nicolau, J. C., Petrie, M. C., Ponikowski, P., Bengtsson, O., Langkilde, A. M., Schou, M., Sjöstrand, M., Solomon, S. D., Sabatine, M. S., & Køber, L. (2021). Dapagliflozin and atrial fibrillation in heart failure with reduced ejection fraction: insights from DAPA‐HF. European Journal of Heart Failure, 24(3), 513–525. https://doi.org/10.1002/ejhf.2381
Butt, J. H., Docherty, K. F., Petrie, M. C., Schou, M., Kosiborod, M. N., O’Meara, E., Katova, T., Ljungman, C. E. A., Diez, M., Ogunniyi, M. O., Langkilde, A. M., Sjöstrand, M., Lindholm, D., Bengtsson, O., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Solomon, S. D., Jhund, P. S., & Køber, L. (2021). Efficacy and Safety of Dapagliflozin in Men and Women With Heart Failure With Reduced Ejection Fraction. JAMA Cardiology, 6(6), 678. https://doi.org/10.1001/jamacardio.2021.0379
Butt, J. H., Jhund, P. S., Belohlávek, J., de Boer, R. A., Chiang, C.-E., Desai, A. S., Drożdzż, J., Hernandez, A. F., Inzucchi, S. E., Katova, T., Kitakaze, M., Kosiborod, M. N., Lam, C. S. P., Langkilde, A. M., Lindholm, D., Bachus, E., Martinez, F., Merkely, B., Petersson, M., & McMurray, J. J. V. (2022). Efficacy and Safety of Dapagliflozin According to Frailty in Patients with Heart Failure: A Prespecified Analysis of the DELIVER Trial. Circulation. https://doi.org/10.1161/circulationaha.122.061754
Butt, J. H., Kondo, T., Jhund, P. S., Comin-Colet, J., de Boer, R. A., Desai, A. S., Hernandez, A. F., Inzucchi, S. E., Janssens, S. P., Kosiborod, M. N., Lam, C. S. P., Langkilde, A. M., Lindholm, D., Martinez, F., Petersson, M., Shah, S. J., Thierer, J., Vaduganathan, M., Verma, S., & McMurray, J. J. (2022). Dapagliflozin, atrial fibrillation, and heart failure with mildly reduced or preserved ejection fraction in DELIVER. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2022.08.718
Butler, J., Filippatos, G., Siddiqi, T. J., Ferreira, J. P., Brueckmann, M., Bocchi, E., Böhm, M., Chopra, V. K., Giannetti, N., Iwata, T., Januzzi, J. L., Kaul, S., Piña, I. L., Ponikowski, P., Rauch-Kröhnert, U., Shah, S. J., Senni, M., Sumin, M., Verma, S., & Anker, S. D. (2022). Effects of Empagliflozin in Women and Men With Heart Failure and Preserved Ejection Fraction. Circulation, 146(14), 1046–1055. https://doi.org/10.1161/circulationaha.122.059755
Cosentino, F., Cannon, C. P., Cherney, D. Z. I., Masiukiewicz, U., Pratley, R., Dagogo-Jack, S., Frederich, R., Charbonnel, B., Mancuso, J., Shih, W. J., Terra, S. G., Cater, N. B., Gantz, I., & McGuire, D. K. (2020). Efficacy of Ertugliflozin on Heart Failure–Related Events in Patients With Type 2 Diabetes Mellitus and Established Atherosclerotic Cardiovascular Disease. Circulation, 142(23), 2205–2215. https://doi.org/10.1161/circulationaha.120.050255
Dekkers, C. C. J., Petrykiv, S., Laverman, G. D., Cherney, D. Z., Gansevoort, R. T., & Heerspink, H. J. L. (2018). Effects of the SGLT-2 inhibitor dapagliflozin on glomerular and tubular injury markers. Diabetes, Obesity and Metabolism, 20(8), 1988–1993. https://doi.org/10.1111/dom.13301
Del Prato, S., Rosenstock, J., Garcia-Sanchez, R., Iqbal, N., Hansen, L., Johnsson, E., Chen, H., & Mathieu, C. (2018). Safety and tolerability of dapagliflozin, saxagliptin and metformin in combination: Post-hoc analysis of concomitant add-on versus sequential add-on to metformin and of triple versus dual therapy with metformin. Diabetes, Obesity and Metabolism, 20(6), 1542–1546. https://doi.org/10.1111/dom.13258
Docherty, K. F., Jhund, P. S., Claggett, B., Ferreira, J. P., Bengtsson, O., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Langkilde, A. M., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Sjöstrand, M., Solomon, S. D., McMurray, J. J. V., McMurray, J. J. V., DeMets, D. L., Inzucchi, S. E., Køber, L., & Ho, D. (2021). Extrapolating Long-term Event-Free and Overall Survival With Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2021.2632
García-Arias, M. R., Gonzaga-López, T. I., del Carmen González-Fernández, N., Guzmán-Ramírez, P. M., Ángeles-Acuña, A., Enríquez-Peregrino, K. G., ... & Cedillo-Rivera, E. A. (2019). Efecto cardiometabólico de los inhibidores del cotransportador sodio glucosa tipo 2 (SGLT2). Medicina interna de México, 34(6), 924-932.
Gliflozinas: más que antidiabéticos orales. Una breve revisión de la literatura. (2021). Revista Uruguaya de Cardiología, 36(1). https://doi.org/10.29277/cardio.36.2.8
Griffin, M., Rao, V. S., Ivey-Miranda, J., Fleming, J., Mahoney, D., Maulion, C., Suda, N., Siwakoti, K., Ahmad, T., Jacoby, D., Riello, R., Bellumkonda, L., Cox, Z., Collins, S., Jeon, S., Turner, J. M., Wilson, F. P., Butler, J., Inzucchi, S. E., & Testani, J. M. (2020). Empagliflozin in Heart Failure. Circulation, 142(11), 1028–1039. https://doi.org/10.1161/circulationaha.120.045691
Herrington, W. G., Savarese, G., Haynes, R., Marx, N., Mellbin, L., Lund, L. H., Dendale, P., Seferovic, P., Rosano, G., Staplin, N., Baigent, C., & Cosentino, F. (2021). Cardiac, renal, and metabolic effects of sodium–glucose co‐transporter 2 inhibitors: a position paper from the European Society of Cardiology ad‐hoc task force on sodium–glucose co‐transporter 2 inhibitors. European Journal of Heart Failure, 23(8), 1260–1275. https://doi.org/10.1002/ejhf.2286
Hussain, M., Elahi, A., Iqbal, J., Ghafoor, M., Rehman, H., & Akhtar, S. (2021). Comparison of Efficacy and Safety Profile of Sodium-Glucose Cotransporter-2 Inhibitors as Add-On Therapy in Patients With Type 2 Diabetes. Cureus. https://doi.org/10.7759/cureus.14268
Inoue, H., Tamaki, Y., Kashihara, Y., Muraki, S., Kakara, M., Hirota, T., & Ieiri, I. (2018). Efficacy of DPP‐4 inhibitors, GLP‐1 analogues, and SGLT2 inhibitors as add‐ons to metformin monotherapy in T2DM patients: a model‐based meta‐analysis. British Journal of Clinical Pharmacology, 85(2), 393–402. https://doi.org/10.1111/bcp.13807
Januzzi, J. L., Zannad, F., Anker, S. D., Butler, J., Filippatos, G., Pocock, S. J., Ferreira, J. P., Sattar, N., Verma, S., Vedin, O., Schnee, J., Iwata, T., Cotton, D., & Packer, M. (2021). Prognostic Importance of NT-proBNP and Effect of Empagliflozin in the EMPEROR-Reduced Trial. Journal of the American College of Cardiology, 78(13), 1321–1332. https://doi.org/10.1016/j.jacc.2021.07.046
Koshizaka, M., Ishikawa, K., Ishikawa, T., Kobayashi, K., Takemoto, M., Horikoshi, T., Shimofusa, R., Takahashi, S., Nagashima, K., Sato, Y., Tatsuno, I., Terano, T., Hashimoto, N., Kuribayashi, N., Uchida, D., & Yokote, K. (2017). Efficacy and safety of ipragliflozin and metformin for visceral fat reduction in patients with type 2 diabetes receiving treatment with dipeptidyl peptidase-4 inhibitors in Japan: a study protocol for a prospective, multicentre, blinded-endpoint phase IV randomised controlled trial (PRIME-V study). BMJ Open, 7(5), Artigo e015766. https://doi.org/10.1136/bmjopen-2016-015766
Kosiborod, M., Cavender, M. A., Fu, A. Z., Wilding, J. P., Khunti, K., Holl, R. W., Norhammar, A., Birkeland, K. I., Jørgensen, M. E., Thuresson, M., Arya, N., Bodegård, J., Hammar, N., & Fenici, P. (2017). Lower Risk of Heart Failure and Death in Patients Initiated on Sodium-Glucose Cotransporter-2 Inhibitors Versus Other Glucose-Lowering Drugs. Circulation, 136(3), 249–259. https://doi.org/10.1161/circulationaha.117.029190
Kosiborod, M., Lam, C. S. P., Kohsaka, S., Kim, D. J., Karasik, A., Shaw, J., Tangri, N., Goh, S.-Y., Thuresson, M., Chen, H., Surmont, F., Hammar, N., Fenici, P., Kosiborod, M., Cavender, M. A., Fu, A. Z., Wilding, J. P., Khunti, K., Norhammar, A., & Magliano, D. (2018). Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs. Journal of the American College of Cardiology, 71(23), 2628–2639. https://doi.org/10.1016/j.jacc.2018.03.009
Kosiborod, M. N., Angermann, C. E., Collins, S. P., Teerlink, J. R., Ponikowski, P., Biegus, J., Comin-Colet, J., Ferreira, J. P., Mentz, R. J., Nassif, M. E., Psotka, M. A., Tromp, J., Brueckmann, M., Blatchford, J. P., Salsali, A., & Voors, A. A. (2022). Effects of Empagliflozin on Symptoms, Physical Limitations and Quality of Life in Patients Hospitalized for Acute Heart Failure - Results From the EMPULSE Trial. Circulation. https://doi.org/10.1161/circulationaha.122.059725
Luo, M., Kong, X., Wang, H., Zhai, X., Cai, T., Ding, B., Hu, Y., Jing, T., Su, X., Li, H., & Ma, J. (2020). Effect of Dapagliflozin on Glycemic Variability in Patients with Type 2 Diabetes under Insulin Glargine Combined with Other Oral Hypoglycemic Drugs. Journal of Diabetes Research, 2020, 1–7. https://doi.org/10.1155/2020/6666403
Nassif, M. E., Qintar, M., Windsor, S. L., Jermyn, R., Shavelle, D. M., Tang, F., Lamba, S., Bhatt, K., Brush, J., Civitello, A., Gordon, R., Jonsson, O., Lampert, B., Pelzel, J., & Kosiborod, M. N. (2021). Empagliflozin Effects on Pulmonary Artery Pressure in Patients With Heart Failure. Circulation, 143(17), 1673–1686. https://doi.org/10.1161/circulationaha.120.052503
Packer, M., Anker, S. D., Butler, J., Filippatos, G., & Zannad, F. (2017). Effects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure. JAMA Cardiology, 2(9), 1025. https://doi.org/10.1001/jamacardio.2017.2275
Packer, M., Anker, S. D., Butler, J., Filippatos, G., Ferreira, J. P., Pocock, S. J., Sattar, N., Brueckmann, M., Jamal, W., Cotton, D., Iwata, T., & Zannad, F. (2021). Empagliflozin in Patients With Heart Failure, Reduced Ejection Fraction, and Volume Overload. Journal of the American College of Cardiology, 77(11), 1381–1392. https://doi.org/10.1016/j.jacc.2021.01.033
Packer, M., Butler, J., Zannad, F., Filippatos, G., Ferreira, J. P., Pocock, S. J., Carson, P., Anand, I., Doehner, W., Haass, M., Komajda, M., Miller, A., Pehrson, S., Teerlink, J. R., Schnaidt, S., Zeller, C., Schnee, J. M., & Anker, S. D. (2021). Effect of Empagliflozin on Worsening Heart Failure Events in Patients with Heart Failure and a Preserved Ejection Fraction: The EMPEROR-Preserved Trial. Circulation. https://doi.org/10.1161/circulationaha.121.056824
Palmer, S. C., Tendal, B., Mustafa, R. A., Vandvik, P. O., Li, S., Hao, Q., Tunnicliffe, D., Ruospo, M., Natale, P., Saglimbene, V., Nicolucci, A., Johnson, D. W., Tonelli, M., Rossi, M. C., Badve, S. V., Cho, Y., Nadeau-Fredette, A.-C., Burke, M., Faruque, L. I., & Strippoli, G. F. M. (2021). Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials. BMJ, m4573. https://doi.org/10.1136/bmj.m4573
Peikert, A., Martinez, F. A., Vaduganathan, M., Claggett, B. L., Kulac, I. J., Desai, A. S., Jhund, P. S., de Boer, R. A., DeMets, D., Hernandez, A. F., Inzucchi, S. E., Kosiborod, M. N., Lam, C. S. P., Shah, S. J., Katova, T., Merkely, B., Vardeny, O., Wilderäng, U., Lindholm, D., & Solomon, S. D. (2022). Efficacy and Safety of Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction According to Age: The DELIVER Trial. Circulation: Heart Failure. https://doi.org/10.1161/circheartfailure.122.010080
Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2019. (2018). Diabetes Care, 42(1), S90—S102. https://doi.org/10.2337/dc19-s009
Powell, D. R., Zambrowicz, B., Morrow, L., Beysen, C., Hompesch, M., Turner, S., Hellerstein, M., Banks, P., Strumph, P., & Lapuerta, P. (2019). Sotagliflozin Decreases Postprandial Glucose and Insulin Concentrations by Delaying Intestinal Glucose Absorption. The Journal of Clinical Endocrinology & Metabolism, 105(4), Artigo e1235-e1249. https://doi.org/10.1210/clinem/dgz258
Pradhan, A., Vohra, S., Vishwakarma, P., & Sethi, R. (2019). Review on sodium-glucose cotransporter 2 inhibitor (SGLT2i) in diabetes mellitus and heart failure. Journal of Family Medicine and Primary Care, 8(6), 1855. https://doi.org/10.4103/jfmpc.jfmpc_232_19
Rådholm, K., Figtree, G., Perkovic, V., Solomon, S. D., Mahaffey, K. W., de Zeeuw, D., Fulcher, G., Barrett, T. D., Shaw, W., Desai, M., Matthews, D. R., & Neal, B. (2018). Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus. Circulation, 138(5), 458–468. https://doi.org/10.1161/circulationaha.118.034222
Rodríguez, J. H., Domínguez, Y. A., & Espinal, O. M. M. (2020). Los inhibidores del cotransportador sodio-glucosa tipo 2 en el tratamiento de la diabetes mellitus. Revista Cubana de Endocrinología, 31(3), 1-15.
Santos-Gallego, C. G., Vargas-Delgado, A. P., Requena, J. A., Garcia-Ropero, A., Mancini, D., Pinney, S., Macaluso, F., Sartori, S., Roque, M., Sabatel-Perez, F., Cordero, A. R., Zafar, M. U., Fergus, I., Atallah-Lajam, F., Contreras, J. P., Varley, C., Moreno, P. R., Abascal, V. M., Lala, A., ... Badimon, J. J. (2020). Randomized Trial of Empagliflozin in Non-Diabetic Patients with Heart Failure and Reduced Ejection Fraction. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2020.11.008
Shen, L., Kristensen, S. L., Bengtsson, O., Böhm, M., de Boer, R. A., Docherty, K. F., Inzucchi, S. E., Katova, T., Køber, L., Kosiborod, M. N., Langkilde, A. M., Lindholm, D., Martinez, M. F. A., O’Meara, E., Nicolau, J. C., Petrie, M. C., Ponikowski, P., Sabatine, M. S., Schou, M., ... McMurray, J. J. V. (2021). Dapagliflozin in HFrEF Patients Treated With Mineralocorticoid Receptor Antagonists. JACC: Heart Failure, 9(4), 254–264. https://doi.org/10.1016/j.jchf.2020.11.009
Singh, J. S. S., Mordi, I. R., Vickneson, K., Fathi, A., Donnan, P. T., Mohan, M., Choy, A. M. J., Gandy, S., George, J., Khan, F., Pearson, E. R., Houston, J. G., Struthers, A. D., & Lang, C. C. (2020). Dapagliflozin Versus Placebo on Left Ventricular Remodeling in Patients With Diabetes and Heart Failure: The REFORM Trial. Diabetes Care, 43(6), 1356–1359. https://doi.org/10.2337/dc19-2187
Solomon, S. D., Jhund, P. S., Claggett, B. L., Dewan, P., Køber, L., Kosiborod, M. N., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Inzucchi, S. E., Desai, A. S., Bengtsson, O., Lindholm, D., Sjostrand, M., Langkilde, A. M., & McMurray, J. J. V. (2020). Effect of Dapagliflozin in Patients With HFrEF Treated With Sacubitril/Valsartan. JACC: Heart Failure, 8(10), 811–818. https://doi.org/10.1016/j.jchf.2020.04.008
Spertus, J. A., Birmingham, M. C., Nassif, M., Damaraju, C. V., Abbate, A., Butler, J., Lanfear, D. E., Lingvay, I., Kosiborod, M. N., & Januzzi, J. L. (2022). The SGLT2 inhibitor canagliflozin in heart failure: the CHIEF-HF remote, patient-centered randomized trial. Nature Medicine, 28(4), 809–813. https://doi.org/10.1038/s41591-022-01703-8
Takebayashi, K., Hara, K., Terasawa, T., Naruse, R., Suetsugu, M., Tsuchiya, T., & Inukai, T. (2017). Effect of canagliflozin on circulating active GLP-1 levels in patients with type 2 diabetes: a randomized trial. Endocrine Journal, 64(9), 923–931. https://doi.org/10.1507/endocrj.ej17-0065
Vaduganathan, M., Claggett, B. L., Jhund, P. S., Cunningham, J. W., Pedro Ferreira, J., Zannad, F., Packer, M., Fonarow, G. C., McMurray, J. J. V., & Solomon, S. D. (2020). Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials. The Lancet, 396(10244), 121–128. https://doi.org/10.1016/s0140-6736(20)30748-0
Vaduganathan, M., Sattar, N., Xu, J., Butler, J., Mahaffey, K. W., Neal, B., Shaw, W., Rosenthal, N., Pfeifer, M., Hansen, M. K., & Januzzi, J. L. (2022). Stress Cardiac Biomarkers, Cardiovascular and Renal Outcomes, and Response to Canagliflozin. Journal of the American College of Cardiology, 79(5), 432–444. https://doi.org/10.1016/j.jacc.2021.11.027
Vardeny, O., Fang, J. C., Desai, A. S., Jhund, P. S., Claggett, B., Vaduganathan, M., de Boer, R. A., Hernandez, A. F., Lam, C. S. P., Inzucchi, S. E., Martinez, F. A., Kosiborod, M. N., DeMets, D., O’Meara, E., Zieroth, S., Comin-Colet, J., Drozdz, J., Chiang, C.-E., Kitakaze, M., ... Solomon, S. D. (2022). Dapagliflozin in heart failure with improved ejection fraction: a prespecified analysis of the DELIVER trial. Nature Medicine. https://doi.org/10.1038/s41591-022-02102-9
Voors, A. A., Angermann, C. E., Teerlink, J. R., Collins, S. P., Kosiborod, M., Biegus, J., Ferreira, J. P., Nassif, M. E., Psotka, M. A., Tromp, J., Borleffs, C. J. W., Ma, C., Comin-Colet, J., Fu, M., Janssens, S. P., Kiss, R. G., Mentz, R. J., Sakata, Y., Schirmer, H., ... Ponikowski, P. (2022). The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial. Nature Medicine, 28(3), 568–574. https://doi.org/10.1038/s41591-021-01659-1
Voors, A. A., Damman, K., Teerlink, J. R., Angermann, C. E., Collins, S. P., Kosiborod, M., Biegus, J., Ferreira, J. P., Nassif, M. E., Psotka, M. A., Tromp, J., Brueckmann, M., Blatchford, J. P., Salsali, A., & Ponikowski, P. (2022). Renal effects of empagliflozin in patients hospitalized for acute heart failure: from the EMPULSE trial. European Journal of Heart Failure. https://doi.org/10.1002/ejhf.2681
Wiviott, S. D., Raz, I., Bonaca, M. P., Mosenzon, O., Kato, E. T., Cahn, A., Silverman, M. G., Zelniker, T. A., Kuder, J. F., Murphy, S. A., Bhatt, D. L., Leiter, L. A., McGuire, D. K., Wilding, J. P. H., Ruff, C. T., Gause-Nilsson, I. A. M., Fredriksson, M., Johansson, P. A., Langkilde, A.-M., & Sabatine, M. S. (2019). Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. New England Journal of Medicine, 380(4), 347–357. https://doi.org/10.1056/nejmoa1812389
Zhang, J., Xing, C., Cheng, X., & He, B. (2022). Canagliflozin combined with metformin versus metformin monotherapy for endocrine and metabolic profiles in overweight and obese women with polycystic ovary syndrome: A single-center, open-labeled prospective randomized controlled trial. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.1003238
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