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Empagliflozine

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https://www.readbyqxmd.com/read/29042392/renal-and-cardiovascular-effects-of-sodium-glucose-cotransporter-2-sglt2-inhibition-in-combination-with-loop-diuretics-in-diabetic-patients-with-chronic-heart-failure-recede-chf-protocol-for-a-randomised-controlled-double-blind-cross-over-trial
#1
Natalie A Mordi, Ify R Mordi, Jagdeep S Singh, Fatima Baig, Anna-Maria Choy, Rory J McCrimmon, Allan D Struthers, Chim C Lang
INTRODUCTION: Type 2 diabetes (T2D) and heart failure (HF) are a frequent combination, where treatment options remain limited. There has been increasing interest around the sodium-glucose cotransporter 2 (SGLT2) inhibitors and their use in patients with HF. Data on the effect of SGLT2 inhibitor use with diuretics are limited. We hypothesise that SGLT2 inhibition may augment the effects of loop diuretics and the benefits of SGLT2 inhibitors may extend beyond those of their metabolic (glycaemic parameters and weight loss) and haemodynamic parameters...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29025406/impact-of-empagliflozin-on-subclinical-left-ventricular-dysfunctions-and-on-the-mechanisms-involved-in-myocardial-disease-progression-in-type-2-diabetes-rationale-and-design-of-the-empa-heart-trial
#2
Andrea Natali, Lorenzo Nesti, Iacopo Fabiani, Enrico Calogero, Vitantonio Di Bello
BACKGROUND: Asymptomatic left ventricular (LV) dysfunction is highly prevalent in type 2 diabetes patients. Unlike the other hypoglycemic drugs, SGLT2 inhibitors have shown potential benefits for reducing cardiovascular death and risk factors, aside from lowering plasma glucose levels. With this study we aim at determining whether the treatment with empagliflozin is associated with an improvement in LV functions in diabetic patients with asymptomatic LV dysfunction against Sitagliptin, which is presumably neutral on myocardial function...
October 12, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29020969/updates-on-cardiovascular-outcome-trials-in-diabetes
#3
REVIEW
Oliver Schnell, Lars Rydén, Eberhard Standl, Antonio Ceriello
In 2008 the Food and Drug Administration introduced a guidance for industry that requires the investigation of cardiovascular outcomes of glucose-lowering medications. Since then, an increasing number of cardiovascular outcome trials have been completed in diabetes patients with high cardiovascular risk for members of the SGLT-2 and DPP4 inhibitors and GLP-1 receptor agonist classes. The trials confirmed cardiovascular safety for all tested anti-hyperglycaemic drugs and, in addition empagliflozin, semaglutide and liraglutide could even reduce cardiovascular risk...
October 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29020355/effects-of-empagliflozin-on-risk-for-cardiovascular-death-and-heart-failure-hospitalization-across-the-spectrum-of-heart-failure-risk-in-the-empa-reg-outcome%C3%A2-trial
#4
David Fitchett, Javed Butler, Philippe van de Borne, Bernard Zinman, John M Lachin, Christoph Wanner, Hans J Woerle, Stefan Hantel, Jyothis T George, Odd Erik Johansen, Silvio E Inzucchi
Aims: Empagliflozin reduced the risk of cardiovascular (CV) death and heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) and established CV disease (CVD) in the EMPA-REG OUTCOME® trial. We investigated whether the benefit of empagliflozin was observed across the spectrum of HF risk. Methods and results: Seven thousand and twenty patients with T2D (HbA1c 7-10% and eGFR > 30 mL/min/1.73 m2) were treated with empagliflozin 10 or 25 mg, or placebo once daily and followed for median 3...
August 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29020326/empagliflozin-across-the-stages-of-diabetic-heart-disease
#5
Francesco Paneni
No abstract text is available yet for this article.
August 30, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29016751/cardiac-effects-of-sglt2-inhibitors-the-sodium-hypothesis
#6
Edoardo Bertero, Leticia Prates Roma, Pietro Ameri, Christoph Maack
The effects of intense glycaemic control on macrovascular complications in patients with type 2 diabetes are incompletely resolved, and many glucose-lowering medications negatively affect cardiovascular outcomes. Recently, the EMPA-REG OUTCOME trial revealed that empagliflozin, an inhibitor of the sodium-glucose cotransporter 2 (SGLT2), substantially reduced the risk of hospitalization for heart failure, death from cardiovascular causes, and all-cause mortality in patients with type 2 diabetes mellitus at high cardiovascular risk...
August 4, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28977090/use-of-sglt-2-inhibitors-in-the-treatment-of-type-2-diabetes-mellitus
#7
Leyna Leite Santos, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, Fabiano Timbó Barbosa
INTRODUCTION: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. OBJECTIVE: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile...
July 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28948541/cost-of-glycemic-target-achievement-with-sodium-glucose-co-transporter-2-inhibitors-in-patients-with-type-2-diabetes-in-the-uk
#8
Marc Evans, Sayeed Achha, Cheryl Neslusan
INTRODUCTION: Diabetes-related costs make up a large portion of healthcare expenditures in the UK. Many of these costs are related to treatment of diabetes-related complications. Reducing HbA1c to <7.0% (53 mmol/mol) reduces the incidence of complications and comorbidities. Metformin plus sulfonylurea is the most common dual oral combination therapy in the UK. The costs of achieving HbA1c <7.0% in patients inadequately controlled on metformin plus sulfonylurea were analyzed for the sodium glucose co-transporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, and empagliflozin from the perspective of the UK National Health System...
September 25, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28934557/a-safety-evaluation-of-empagliflozin-plus-linagliptin-for-treating-type-2-diabetes
#9
Baptist Gallwitz
Dipeptidyl-peptidase-IV inhibitors (DPP-4i) and sodium-glucose-transporter-2 inhibitors (SGLT-2i) are oral antidiabetic drugs that improve glycemic parameters and possess a very low intrinsic hypoglycemia risk and favorable cardiovascular data. Areas covered: An overview on the clinical studies investigating the combination therapy with the DPP-4i linagliptin and the SGLT-2i empagliflozin is given. The clinical evidence for the efficacy and safety of free combinations as well as for their fixed dose combinations is presented...
October 11, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28926495/bolstering-your-armamentarium-with-sglt2-inhibitors
#10
Lucia M Novak, Davida F Kruger
Sodium-glucose cotransporter-2 inhibitors have a unique mechanism of action in the kidneys that causes glucosuria, which lowers plasma glucose. They are also associated with reduced body weight and BP, and a low incidence of hypoglycemia. This article reviews the pharmacologic profiles and clinical implications of canagliflozin, dapagliflozin, and empagliflozin.
October 18, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28904068/empagliflozin-and-clinical-outcomes-in-patients-with-type-2-diabetes-established-cardiovascular-disease-and-chronic-kidney-disease
#11
Christoph Wanner, John M Lachin, Silvio E Inzucchi, David Fitchett, Michaela Mattheus, Jyothis T George, Hans-Juergen Woerle, Uli C Broedl, Maximilian von Eynatten, Bernard Zinman
Background -Empagliflozin, a sodium glucose cotransporter 2 inhibitor, reduced cardiovascular morbidity and mortality in patients with type 2 diabetes and established cardiovascular disease in the EMPA-REG OUTCOME(®) trial. Urinary glucose excretion with empagliflozin decreases with declining renal function, resulting in less potency for glucose lowering in patients with kidney disease. We investigated the effects of empagliflozin on clinical outcomes in patients with type 2 diabetes, established cardiovascular disease and chronic kidney disease...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28895030/type-2-diabetes-and-cardiovascular-prevention-the-dogmas-disputed
#12
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo...
September 11, 2017: Endocrine
https://www.readbyqxmd.com/read/28887847/fournier-s-gangrene-in-a-man-on-empagliflozin-for-treatment-of-type-2-diabetes
#13
S Kumar, A J Costello, P G Colman
Use of sodium glucose co-transporter 2 (SLGT2) inhibitors has been associated with an increased risk of genital infections secondary to increased glycosuria [1]. Our report highlights a case of Fournier's gangrene, the most severe and potentially fatal type of genital infection, which was preceded by multiple episodes of thrush in a man treated with empagliflozin for Type 2 diabetes. This article is protected by copyright. All rights reserved.
September 8, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28879786/pharmacological-management-of-type-2-diabetes-what-s-new-in-2017
#14
André J Scheen
Introduction Novelties in the management of type 2 diabetes are dominated by the commercialisation of new glucose-lowering agents, which offer alternatives to older antidiabetic medications, and by the publication of several prospective placebo-controlled outcome trials, which demonstrated not only cardiovascular safety but also cardiovascular and renal protection with some new medications. Areas covered Updates regarding the use of glucose-lowering agents are discussed from a clinical point of view. Some new viewpoints concern older antidiabetic agents such as metformin, sulfonylureas and glitazones whose benefit-risk balance has been revisited, especially in high risk patients...
September 7, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28870145/real-world-use-and-modeled-impact-of-glucose-lowering-therapies-evaluated-in-recent-cardiovascular-outcomes-trials-an-ncdr%C3%A2-research-to-practice-project
#15
Suzanne V Arnold, Silvio E Inzucchi, Fengming Tang, Darren K McGuire, Sanjeev N Mehta, Thomas M Maddox, Abhinav Goyal, Laurence S Sperling, Daniel Einhorn, Nathan D Wong, Kamlesh Khunti, Carolyn Sp Lam, Mikhail Kosiborod
Aims Recent trials (EMPA-REG OUTCOME and Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results [LEADER]) have shown improved cardiovascular (CV) mortality with specific currently available glucose-lowering medications (empagliflozin and liraglutide, respectively), but were limited to selected patient populations. We sought to evaluate the current use and potential real-world impact of empagliflozin (and other sodium-glucose co-transporter 2 inhibitors [SGLT2is]) and liraglutide (and other glucagonlike peptide-1 receptor agonist [GLP-1 RAs]) among patients in the Diabetes Collaborative Registry (DCR)...
October 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28864828/-severe-atypical-ketoacidosis-due-to-sglt2-inhibitor-therapy-two-case-reports
#16
T G K Breuer, K Kampmann, A Wutzler, C Steinfort, W Uhl, W E Schmidt, J J Meier
Two female patients were admitted due to ketoacidosis. Serum glucose was moderately elevated. The patients exhibited abdominal and neurologic symptoms. Treatment consisted of metformin, insulin glargin and empagliflozin, as well as glimepiride, insulin detemir and empagliflozin, respectively. Treatment with intravenous fluid replacement, insulin, glucose, potassium and buffer solution led to a normalisation of pH and serum glucose levels. Our report describes two cases of atypical ketoacidosis with moderately elevated serum glucose during sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy...
September 1, 2017: Der Internist
https://www.readbyqxmd.com/read/28860019/pooled-analysis-of-phase-iii-trials-indicate-contrasting-influences-of-renal-function-on-blood%C3%A2-pressure-body-weight-and-hba1c-reductions-with-empagliflozin
#17
David Z I Cherney, Mark E Cooper, Ilkka Tikkanen, Egon Pfarr, Odd Erik Johansen, Hans J Woerle, Uli C Broedl, Søren S Lund
Sodium glucose cotransporter 2 (SGLT2) inhibitors reduce HbA1c, blood pressure, and weight in patients with type 2 diabetes. To investigate the effect of renal function on reductions in these parameters with the SGLT2 inhibitor empagliflozin, we assessed subgroups by baseline estimated glomerular filtration rate (eGFR; Modification of Diet in Renal Disease) in pooled data from five 24-week trials of 2286 patients with type 2 diabetes randomized to empagliflozin or placebo. Reductions in HbA1c with empagliflozin versus placebo significantly diminished with decreasing baseline eGFR...
August 28, 2017: Kidney International
https://www.readbyqxmd.com/read/28846182/effects-of-sodium-glucose-co-transporter-2-sglt2-inhibitors-on-serum-uric-acid-level-a-meta-analysis-of-randomized-controlled-trials
#18
Yumo Zhao, Lubin Xu, Dongli Tian, Peng Xia, Hua Zheng, Li Wang, Limeng Chen
To describe the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM), PubMed, CENTRAL, EMBASE, and ClinicalTrials.gov were searched for randomized controlled trials of SGLT2 inhibitors in patients with T2DM up to 20 May 2017. Sixty-two studies totaling 34,941 patients were included. Either SGLT2 inhibitor (empagliflozin, canagliflozin, dapagliflozin, tofogliflozin, luseogliflozin or ipragliflozin) significantly decreased SUA levels compared with control (total WMD -37...
August 28, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28845675/acute-hepatitis-caused-by-empagliflozin-in-a-nonalcoholic-fatty-liver-disease-patient
#19
Giuseppe Famularo, Maria Rosaria Sajeva, Gisella Marino, Claudio Granato
No abstract text is available yet for this article.
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28844525/oral-antidiabetic-agents-and-cardiovascular-outcomes
#20
Manan Pareek, Deepak L Bhatt
Cardiovascular disease is the leading cause of morbidity and mortality among patients with type 2 diabetes; however, a direct protective effect of tight glycemic control remains unproven. In fact, until 2008, when concerns related to rosiglitazone prompted regulatory agencies to mandate assessment of cardiovascular safety of new antidiabetic agents, little was known about how these medications affected cardiovascular outcomes. Since then, there has been a considerable increase in the number of cardiovascular trials, which employ a noninferiority design and focus on high-risk populations to establish safety in the shortest time possible...
July 29, 2017: Current Problems in Cardiology
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