Flozins - New Revolution Has Started

Topic Information

Dear Colleagues,

SGLT2 inhibitors (flozins) have well-established clinical indications in the treatment of type 2 diabetes, chronic kidney disease, heart failure with reduced and preserved left ventricular ejection fraction. Currently, the important role of SGLT-2 inhibitors is also being discovered in the treatment of arterial hypertension, metabolic-associated fatty liver disease, anemia and long-COVID syndromes. SGLT2 inhibitors freed themselves from the odium of nephrological-diabetological-cardiovascular drugs, with recent data showing that their use is multidirectional and related to presence of SGLTs present in many organs. The revolutionary role of SGLT2 inhibitors was summarized by prof. Eugene Braunwald - the legend of world cardiology, stating that these drugs are "the statins of the 21st century". We invite you to submit review papers, systematic reviews, meta-analyses and original studies for our multidisciplinary topic "Flozins - New Revolution Has Started", in which we would like to collect the latest and most interesting data on SGLT2 inhibitors.

Prof. Dr. Krzysztof J. Filipiak
Dr. Aleksandra Gąsecka
Topic Editors

Stanisław Surma
Topic Editor Assistant

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Journal of Cardiovascular Development and Disease jcdd	2.4	2.6	2014	25.7 Days	CHF 2700
Metabolites metabolites	3.5	5.7	2011	16.1 Days	CHF 2700
Hearts hearts	-	-	2020	18.6 Days	CHF 1000
Medicines medicines	-	-	2014	28.6 Days	CHF 1400

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Published Papers (4 papers)

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11 pages, 692 KiB  

Open AccessReview

SGLT2 Inhibitors in Long COVID Syndrome: Is There a Potential Role?

by Paul Zimmermann, Harald Sourij, Felix Aberer, Sian Rilstone, Janis Schierbauer and Othmar Moser

J. Cardiovasc. Dev. Dis. 2023, 10(12), 478; https://doi.org/10.3390/jcdd10120478 - 29 Nov 2023

Cited by 2 | Viewed by 2715

Abstract

The coronavirus disease (COVID)-19 has turned into a pandemic causing a global public health crisis. While acute COVID-19 mainly affects the respiratory system and can cause acute respiratory distress syndrome, an association with persistent inflammatory stress affecting different organ systems has been elucidated [...] Read more.

The coronavirus disease (COVID)-19 has turned into a pandemic causing a global public health crisis. While acute COVID-19 mainly affects the respiratory system and can cause acute respiratory distress syndrome, an association with persistent inflammatory stress affecting different organ systems has been elucidated in long COVID syndrome (LCS). Increased severity and mortality rates have been reported due to cardiophysiological and metabolic systemic disorders as well as multiorgan failure in COVID-19, additionally accompanied by chronic dyspnea and fatigue in LCS. Hence, novel therapies have been tested to improve the outcomes of LCS of which one potential candidate might be sodium–glucose cotransporter 2 (SGLT2) inhibitors. The aim of this narrative review was to discuss rationales for investigating SGLT2 inhibitor therapy in people suffering from LCS. In this regard, we discuss their potential positive effects—next to the well described “cardio-renal-metabolic” conditions—with a focus on potential anti-inflammatory and beneficial systemic effects in LCS. However, potential beneficial as well as potential disadvantageous effects of SGLT2 inhibitors on the prevalence and long-term outcomes of COVID-19 will need to be established in ongoing research. Full article

(This article belongs to the Topic Flozins - New Revolution Has Started)

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35 pages, 3524 KiB  

Open AccessReview

The Ketogenic Effect of SGLT-2 Inhibitors—Beneficial or Harmful?

by Michail Koutentakis, Jakub Kuciński, Damian Świeczkowski, Stanisław Surma, Krzysztof J. Filipiak and Aleksandra Gąsecka

J. Cardiovasc. Dev. Dis. 2023, 10(11), 465; https://doi.org/10.3390/jcdd10110465 - 16 Nov 2023

Cited by 7 | Viewed by 4649

Abstract

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors, also called gliflozins or flozins, are a class of drugs that have been increasingly used in the management of type 2 diabetes mellitus (T2DM) due to their glucose-lowering, cardiovascular (CV), and renal positive effects. However, recent studies suggest that [...] Read more.

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors, also called gliflozins or flozins, are a class of drugs that have been increasingly used in the management of type 2 diabetes mellitus (T2DM) due to their glucose-lowering, cardiovascular (CV), and renal positive effects. However, recent studies suggest that SGLT-2 inhibitors might also have a ketogenic effect, increasing ketone body production. While this can be beneficial for some patients, it may also result in several potential unfavorable effects, such as decreased bone mineral density, infections, and ketoacidosis, among others. Due to the intricate and multifaceted impact caused by SGLT-2 inhibitors, this initially anti-diabetic class of medications has been effectively used to treat both patients with chronic kidney disease (CKD) and those with heart failure (HF). Additionally, their therapeutic potential appears to extend beyond the currently investigated conditions. The objective of this review article is to present a thorough summary of the latest research on the mechanism of action of SGLT-2 inhibitors, their ketogenesis, and their potential synergy with the ketogenic diet for managing diabetes. The article particularly discusses the benefits and risks of combining SGLT-2 inhibitors with the ketogenic diet and their clinical applications and compares them with other anti-diabetic agents in terms of ketogenic effects. It also explores future directions regarding the ketogenic effects of SGLT-2 inhibitors. Full article

(This article belongs to the Topic Flozins - New Revolution Has Started)

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20 pages, 729 KiB  

Open AccessReview

SGLT2 Inhibitors vs. GLP-1 Agonists to Treat the Heart, the Kidneys and the Brain

by Bartosz Rolek, Mateusz Haber, Magdalena Gajewska, Sylwester Rogula, Arkadiusz Pietrasik and Aleksandra Gąsecka

J. Cardiovasc. Dev. Dis. 2023, 10(8), 322; https://doi.org/10.3390/jcdd10080322 - 30 Jul 2023

Cited by 17 | Viewed by 9227

Abstract

Sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like-peptide-1 receptor (GLP-1-R) agonists are novel therapeutic agents used for the management of type 2 diabetes mellitus (T2DM). Recently, large-scale randomized clinical trials have been conducted to assess the cardiovascular safety of these medications. The findings [...] Read more.

Sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like-peptide-1 receptor (GLP-1-R) agonists are novel therapeutic agents used for the management of type 2 diabetes mellitus (T2DM). Recently, large-scale randomized clinical trials have been conducted to assess the cardiovascular safety of these medications. The findings of these trials have revealed that both SGLT2 inhibitors and GLP-1-R agonists exhibit favorable cardioprotective effects, including reduction in cardiovascular and all-cause mortality, a decreased risk of chronic kidney disease progression, a decrease in hospitalization for heart failure (HF), an effect shown by SGLT2 inhibitors, and stroke prevention, an effect shown by GLP-1-R agonists. Based on the results from above studies, the European and American Diabetes Associations have issued new recommendations strongly endorsing the use of SGLT2 inhibitors and GLP-1-R agonists in combination with metformin for patients with T2DM who have additional cardiovascular (CV) comorbidities or risk factors. The primary aim of this combined therapy is to prevent CV events. Although both medication groups offer beneficial effects, they demonstrate slightly different profiles. SGLT2 inhibitors have exhibited better effects regarding a reduced incidence of HF, whereas GLP-1-R agonists have shown a reduced risk of CV events, particularly stroke. Moreover, recent European Society of Cardiology as well as American College of Cardiology and American Heart Association guidelines of HF treatment stressed the importance of SGLT2 inhibitor administration in patients with HF regardless of T2DM. In this context, we present and discuss the outcomes of the most recent trials investigating the impact of SGLT2 inhibitors and GLP-1-R agonists on renal and cardiovascular outcomes in patients, both with and without T2DM. Additionally, we explore the synergistic effects of combining SGLT2 inhibitors and GLP-1-R agonists in patients with cardiovascular disease. Full article

(This article belongs to the Topic Flozins - New Revolution Has Started)

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18 pages, 1282 KiB  

Open AccessReview

Sodium–Glucose Cotransporter 2 Inhibitors to Decrease the Uric Acid Concentration—A Novel Mechanism of Action

by Anna Kochanowska, Przemysław Rusztyn, Karolina Szczerkowska, Stanisław Surma, Aleksandra Gąsecka, Miłosz J. Jaguszewski, Łukasz Szarpak and Krzysztof J. Filipiak

J. Cardiovasc. Dev. Dis. 2023, 10(7), 268; https://doi.org/10.3390/jcdd10070268 - 22 Jun 2023

Cited by 9 | Viewed by 2702

Abstract

Sodium–glucose cotransporter 2 inhibitors (SGLT2is) are glucose-lowering agents whose positive impact on cardiovascular risk has been described extensively. Not only do they influence lipid profile, blood pressure, atherosclerosis risk, hemoglobin level, and insulin resistance, but they also reduce cardiovascular events, all-cause mortality, and [...] Read more.

Sodium–glucose cotransporter 2 inhibitors (SGLT2is) are glucose-lowering agents whose positive impact on cardiovascular risk has been described extensively. Not only do they influence lipid profile, blood pressure, atherosclerosis risk, hemoglobin level, and insulin resistance, but they also reduce cardiovascular events, all-cause mortality, and hospitalization rates. Some of these effects may be due to their impact on serum uric acid (SUA) concentration. Findings from nine meta-analyses showed that, indeed, SGLT2is significantly reduce SUA. The data on the drug- and dose-dependency of this effect were inconclusive. Several factors alternating the beneficial effects of SGLT2is on SUA, such as glycated hemoglobin concentration (HbA1c), presence of diabetes, and baseline SUA level, were described. Even though there is a consensus that the lowering of SUA by SGLT2is might be due to the increased urinary excretion rate of uric acid (UEUA) rather than its altered metabolism, the exact mechanism remains unknown. The influence of SGLT2is on SUA may not only be used in gout treatment but may also be of huge importance in explaining the observed pleiotropic effects of SGLT2is. Full article

(This article belongs to the Topic Flozins - New Revolution Has Started)
(This article belongs to the Section Cardiovascular Clinical Research)

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