Kidney Week

Abstract: PUB153

Role of SGLT2 Inhibitors in Treating Lupus Nephritis: An Updated Systematic Review

Session Information

• Publication Only

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Noor, Atiqa, King Edward Medical University, Lahore, Punjab, Pakistan

Atiqa Noor, MBBS

• Kuraku, Dileep Raja, Vinnic'kij nacional'nij medicnij universitet imeni Mikoli Pirogova, Vinnytsia, Vinnytsia Oblast, Ukraine

Dileep Raja Kuraku, MD

• Amin, Fahad, King Edward Medical University, Lahore, Punjab, Pakistan

Fahad Amin, MBBS

• Rehman, Saqib, University of Health Sciences Lahore, Lahore, Punjab, Pakistan

Saqib Rehman, MBBS

• Keshapogu, Nagarjuna, Vinnic'kij nacional'nij medicnij universitet imeni Mikoli Pirogova, Vinnytsia, Vinnytsia Oblast, Ukraine

Nagarjuna Keshapogu, MD

• Zulfiqar, Rumaisa, Karachi Medical and Dental College, Karachi, Sindh, Pakistan

Rumaisa Zulfiqar, MBBS

• Attaluri, Durga Manaswini, Sri Aurobindo Institute of Medical Sciences, Indore, MP, India

Durga Manaswini Attaluri, MD

• Thiyagarajan, Ragav Vikraman, MAHSA University, Federal Territory of Kuala Lumpur, Malaysia

Ragav Vikraman Thiyagarajan, MBBS

• Vijayarao, Sree Sindhu, University of Miami Miller School of Medicine, Miami, Florida, United States

Sree Sindhu Vijayarao, MBBS

• Patel, Divya, Gujarat Medical Education and Research Society, Gandhinagar, GJ, India

Divya Patel, MD

Background

A common autoimmune disease in the world, systemic lupus erythematosus (SLE) is caused by a lack of tolerance to self-antigens. SLE can have effects on the renal system, called lupus nephritis (LN). If left untreated, nephron inflammation can lead to renal failure. Lupus nephritis is currently treated with a variety of immunosuppressive and biologic agents. Many of these agents are used off-label and are associated with a risk of serious side effects. This has led to emerging interest in the potential kidney-protective benefits of Sodium Glucose Transporter 2 (SGLT2) inhibitors.

Methods

A literature search was conducted electronically using PubMed, Google Scholar, ClinicalTrials.gov, and Cochrane Central databases. Eligible studies included randomized controlled trials, observational, and cohort studies. Exclusion criteria included diagnosis of kidney diseases other than LN. Data were extracted on demographics, type, and dose of SGLT2 inhibitors used, and their effects on renal outcomes.

Results

A total of 1821 records were initially screened, 10 records were included, and secondary screening gave 8 final records. Three RCTs, one single-arm trial, and four observational studies were included, with a population size of 4,502, with a mean age ranging from 33 to 65 years. Dapagliflozin 10mg was the treatment in most studies, while others didn’t specify the SGLT2 inhibitor. SGLT2 inhibitors showed improvement or stabilization of renal function and a reduction in proteinuria ranging from roughly 37.6% to 65.2% throughout the included studies. The reported improvement in eGFR was as high as 17.2 mL/min.

Conclusion

There is evidence that these drugs may improve renal outcomes by increasing GFR and reducing proteinuria. SGLT-2 inhibitor use in LN has great potential. Further research and clinical trials will be needed to definitively establish their role in controlling LN and possibly improving patient outcomes. Moving forward, identifying biomarkers that will help identify which patients would benefit most from SGLT-2 inhibitors is important.