A recent study has uncovered promising results for people living with both type 2 diabetes and chronic kidney disease (CKD), revealing that a medication already approved for treating these conditions may also significantly lower the risk of heart attack and stroke. The study, published in The Lancet Diabetes & Endocrinology, specifically highlights the potential benefits of sotagliflozin, a drug that blocks both the SGLT1 and SGLT2 receptors in the body.
Type 2 diabetes and CKD are both chronic conditions linked to an increased risk of cardiovascular complications such as stroke and heart attack. An estimated 828 million people worldwide live with diabetes, and approximately one in three of those with type 2 diabetes also have CKD. Additionally, it is estimated that 840 million people suffer from CKD globally, a disease that progressively damages the kidneys, leading to a loss of function.
The study, which analyzed data from the SCORED trial—a multicenter clinical trial involving nearly 10,600 participants—focused on individuals with type 2 diabetes, CKD, and increased cardiovascular risks. The participants were either given a placebo or sotagliflozin over a period of about 16 months, starting in 2017.
The results were promising. Those who took sotagliflozin experienced a 23% reduction in the risk of heart attack, stroke, and cardiovascular-related death compared to those taking the placebo. Remarkably, these benefits appeared within just three months of starting the drug. Further analysis revealed a 32% reduction in heart attacks and a 34% reduction in strokes for those taking sotagliflozin.
Deepak L. Bhatt, MD, MPH, MBA, the lead author of the study and director at Mount Sinai Fuster Heart Hospital, highlighted the significance of these findings, noting that people with type 2 diabetes and CKD face an elevated risk of cardiovascular issues. “We need new therapies to help reduce these risks,” Bhatt said.
Sotagliflozin works by blocking both the SGLT2 receptor, which is found in the kidneys, and the SGLT1 receptor, which is located in the kidneys, heart, gut, and brain. The dual inhibition of these receptors may explain why sotagliflozin is able to reduce the risk of heart attack and stroke—an effect not seen with other medications that only block the SGLT2 receptor.
Michael Broukhim, MD, an interventional cardiologist at Providence Saint John’s Health Center, commented on the study’s impact, stating, “If sotagliflozin has the added benefit of reducing myocardial infarction and stroke, we may wish to use this agent more to treat high-risk patients.” He emphasized that type 2 diabetes and kidney disease patients have significantly elevated risks for heart attack and stroke, and additional treatments could improve patient outcomes.
Looking ahead, Bhatt believes that sotagliflozin should be studied in other high-risk populations, although he noted that long-term trials would be necessary to confirm its broad effectiveness. For now, ongoing smaller experiments are exploring the drug’s biological actions, which could further explain its unique ability to reduce cardiovascular risks.
