Optimising the Heart Failure Treatment Pathway: The Role of SGLT2 Inhibitors

Drugs. 2021 Jul;81(11):1243-1255. doi: 10.1007/s40265-021-01538-6. Epub 2021 Jun 23.

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors were first developed as glucose-lowering therapies for the treatment of diabetes. However, these drugs have now been recognised to prevent worsening heart-failure events, improve health-related quality of life, and reduce mortality in people with heart failure with reduced ejection fraction (HFrEF), including those both with and without diabetes. Despite robust clinical trial data demonstrating favourable outcomes with SGLT2 inhibitors for patients with HFrEF, there is a lack of familiarity with the HF indication for these drugs, which have been the remit of diabetologists to date. In this article we use consensus expert opinion alongside the available evidence and label indication to provide support for the healthcare community treating people with HF regarding positioning of SGLT2 inhibitors within the treatment pathway. By highlighting appropriate prescribing and practical considerations, we hope to encourage greater, and safe, use of SGLT2 inhibitors in this population.

MeSH terms

  • Cardiovascular Agents / therapeutic use
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology
  • Drug Therapy, Combination
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Heart Failure / mortality
  • Humans
  • Multicenter Studies as Topic
  • Practice Guidelines as Topic
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors / economics
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*
  • Stroke Volume / drug effects

Substances

  • Cardiovascular Agents
  • Sodium-Glucose Transporter 2 Inhibitors