The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?

Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient’s history of diabetes mellitus (DM). SGLT2is suppressed cardiovascular adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced the risk of worsening heart failu...

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Main Authors: Ayami Naito, Yuji Nagatomo, Akane Kawai, Midori Yukino-Iwashita, Ryota Nakazawa, Akira Taruoka, Asako Takefuji, Risako Yasuda, Takumi Toya, Yukinori Ikegami, Nobuyuki Masaki, Yasuo Ido, Takeshi Adachi
Format: Article
Language:English
Published: MDPI AG 2024-01-01
Series:Journal of Personalized Medicine
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Online Access:https://www.mdpi.com/2075-4426/14/2/141
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author Ayami Naito
Yuji Nagatomo
Akane Kawai
Midori Yukino-Iwashita
Ryota Nakazawa
Akira Taruoka
Asako Takefuji
Risako Yasuda
Takumi Toya
Yukinori Ikegami
Nobuyuki Masaki
Yasuo Ido
Takeshi Adachi
author_facet Ayami Naito
Yuji Nagatomo
Akane Kawai
Midori Yukino-Iwashita
Ryota Nakazawa
Akira Taruoka
Asako Takefuji
Risako Yasuda
Takumi Toya
Yukinori Ikegami
Nobuyuki Masaki
Yasuo Ido
Takeshi Adachi
author_sort Ayami Naito
collection DOAJ
description Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient’s history of diabetes mellitus (DM). SGLT2is suppressed cardiovascular adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced the risk of worsening heart failure (HF) events or cardiovascular death in patients with HF. Along with these research findings, SGLT-2is are recommended for patients with HF in the latest guidelines. Despite these benefits, the concern surrounding the increasing risk of body weight loss and other adverse events has not yet been resolved, especially for patients with sarcopenia or frailty. The DAPA-HF and DELIVER trials consistently showed the efficacy and safety of SGLT-2i for HF patients with frailty. However, the Rockwood frailty index that derived from a cumulative deficit model was employed for frailty assessment in these trials, which might not be suitable for the evaluation of physical frailty or sarcopenia alone. There is no fixed consensus on which evaluation tool to use or its cutoff value for the diagnosis and assessment of frailty in HF patients, or which patients can receive SGLT-2i safely. In this review, we summarize the methodology of frailty assessment and discuss the efficacy and safety of SGLT-2i for HF patients with sarcopenia or frailty.
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spelling doaj.art-3f54e617974d45ef981fbbc65ad26c772024-02-23T15:23:40ZengMDPI AGJournal of Personalized Medicine2075-44262024-01-0114214110.3390/jpm14020141The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?Ayami Naito0Yuji Nagatomo1Akane Kawai2Midori Yukino-Iwashita3Ryota Nakazawa4Akira Taruoka5Asako Takefuji6Risako Yasuda7Takumi Toya8Yukinori Ikegami9Nobuyuki Masaki10Yasuo Ido11Takeshi Adachi12Department of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Intensive Care, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Cardiology, National Defense Medical College, Tokorozawa 359-8513, JapanSodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient’s history of diabetes mellitus (DM). SGLT2is suppressed cardiovascular adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced the risk of worsening heart failure (HF) events or cardiovascular death in patients with HF. Along with these research findings, SGLT-2is are recommended for patients with HF in the latest guidelines. Despite these benefits, the concern surrounding the increasing risk of body weight loss and other adverse events has not yet been resolved, especially for patients with sarcopenia or frailty. The DAPA-HF and DELIVER trials consistently showed the efficacy and safety of SGLT-2i for HF patients with frailty. However, the Rockwood frailty index that derived from a cumulative deficit model was employed for frailty assessment in these trials, which might not be suitable for the evaluation of physical frailty or sarcopenia alone. There is no fixed consensus on which evaluation tool to use or its cutoff value for the diagnosis and assessment of frailty in HF patients, or which patients can receive SGLT-2i safely. In this review, we summarize the methodology of frailty assessment and discuss the efficacy and safety of SGLT-2i for HF patients with sarcopenia or frailty.https://www.mdpi.com/2075-4426/14/2/141sodium-glucose cotransporter-2 (SGLT-2) inhibitorsheart failurefrailtysarcopenia
spellingShingle Ayami Naito
Yuji Nagatomo
Akane Kawai
Midori Yukino-Iwashita
Ryota Nakazawa
Akira Taruoka
Asako Takefuji
Risako Yasuda
Takumi Toya
Yukinori Ikegami
Nobuyuki Masaki
Yasuo Ido
Takeshi Adachi
The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
Journal of Personalized Medicine
sodium-glucose cotransporter-2 (SGLT-2) inhibitors
heart failure
frailty
sarcopenia
title The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
title_full The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
title_fullStr The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
title_full_unstemmed The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
title_short The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?
title_sort safety and efficacy of sodium glucose cotransporter 2 inhibitors for patients with sarcopenia or frailty double edged sword
topic sodium-glucose cotransporter-2 (SGLT-2) inhibitors
heart failure
frailty
sarcopenia
url https://www.mdpi.com/2075-4426/14/2/141
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