Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors: Indications, Safety, and Efficacy Experienced at Yaoundé General Hospital

Abstract

Introduction : Sodium-glucose co-transporter type 2 (SGLT2) inhibitors have demonstrated proven cardiovascular and renal benefits in the Caucasian population, independent of diabetes. Their use extends to cardio-nephrology. This study aims to evaluate their use in cardiology and nephrology at the Yaoundé General Hospital (YGH). Methods: This was an observational study with retrospective and prospective data collection that included adult patients on SGLT2 inhibitors for at least three months. Sociodemographic, clinical, paraclinical, therapeutic, and evolutionary variables were collected after a review of adult case files of patients who had been on SGLT2 inhibitor treatment for at least 3 months for chronic kidney or heart disease. Outcomes were left ventricular ejection fraction (LVEF), blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria. Associations between variables were analyzed with a 95% confidence interval (CI) at a significance level of 5%. Results: A total of 101 patients were included (61.4% men, median age 70 years [62.5 – 78]). Side effects were: 3 cases of urinary tract infections and 1 case of amputation. Improvements in systolic ( p < 0.001), diastolic ( p < 0.001), and LVEF ( p < 0.001) blood pressure were observed. eGFR improved with a median increase from 42 [26 – 69] mL/min/1.73m 2 to 45 [24.5 – 64] mL/min/1.73m 2 ( p < 0.001), serum creatinine from 16.6 [11.3 – 23.8] mg/L to 15.2 [11.8 – 25.9] mg/L, and proteinuria from 0.7 [0.3 – 0.9] g/g to 0.5 [0.3 – 0.7] g/g. Men (OR = 7.5; p = 0.039) and patients receiving concomitant renin-angiotensin-aldosterone system blocker (OR = 10.2; p = 0.018) had more observed benefits. Good adherence (Morisky score = 0) was strongly associated with perceived benefits (OR = 9.26; p = 0.001). Conclusion : SGLT2 inhibitors are effective and well tolerated in the cardio-nephrological context in Yaoundé, with significant clinical benefits and few adverse effects.