Abstract: FR-PO0546
Sodium-Glucose Cotransporter 2 Inhibitors Among Middle-Aged and Older Adults with Lupus Nephritis
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Sim, Jovan Sao Ang, Lee Kong Chian School of Medicine, Singapore, Singapore
- Hee Jin Veronica, Ng, Lee Kong Chian School of Medicine, Singapore, Singapore
- Tan, Hui Zhuan, Singapore General Hospital, Singapore, Singapore
- Mok, Irene Yanjia, Singapore General Hospital, Singapore, Singapore
- Lee, Tung Lin, Singapore General Hospital, Singapore, Singapore
- Choo Chon Jun, Jason, Singapore General Hospital, Singapore, Singapore
- Lim, Cynthia Ciwei, Singapore General Hospital, Singapore, Singapore
Background
Patients diagnosed with lupus nephritis (LN) have greater cardiovascular (CV) risks due to disease-related immune dysregulation, chronic kidney disease (CKD) and immunosuppressants. While SGLT2i reduce CKD progression and CV events in CKD, their use in LN remains poorly characterised. Emerging post-hoc trial data suggest potential benefit in LN. We aimed to describe real-world SGLT2i prescribing among middle-aged/older adults with LN receiving immunosuppression.
Methods
A single-centre retrospective cohort study included individuals with biopsy-confirmed LN diagnosed from Oct 2015 to May 2025. Six-monthly follow-up visits were included if patients were ≥40 years and receiving immunosuppressants; visits missing SGLT2i prescription data were excluded. The outcome was SGLT2i prescription prevalence. Associated factors were evaluated using mixed-effects logistic regression.
Results
Among 110 individuals with 1,053 follow-up visits, 80 individuals contributing 606 visits between May 2016 and January 2026 had complete SGLT2i prescription data. Median follow-up was 24 months (IQR 12–36). At follow-up visits, median age was 52.5 years, eGFR 92.5 ml/min/1.73m2, and UPCR 0.36 g/g. SGLT2i were prescribed at 30 visits (5.0%) among 8 LN patients aged ≥40 years receiving immunosuppression. Prescription was more frequent in LN patients with T2DM than without T2DM (37.5% vs 5.4%). After adjustment for patient and treatment year, SGLT2i prescription was associated with older age, diabetes mellitus, and metformin, calcium channel blocker, and statin use.
Conclusion
SGLT2i was infrequently prescribed during LN follow-up and were associated with concurrent cardiometabolic risk factors, including older age and pharmacotherapy for diabetes, hypertension and hyperlipidemia. Future studies on SGLT2i safety and benefit in LN may inform uptake in this high-risk group.
Acknowledgment
The authors thank the Renal Coordinator Unit and the Renal Diagnostic Unit of the Department of Renal Medicine, Singapore General Hospital for their support in the project.
Statement of Ethics: This study was conducted according to the Declaration of Helsinki and was approved by the SingHealth Central Institutional Review Board (2024-3941) including waiver of written informed consent based on ethical consideration.