Use of SGLT2 inhibitors and occurrence of noninfectious respiratory disorders: a meta-analysis of large randomized trials of SGLT2 inhibitors

• Published in: Endocrine Vol. 73; no. 1; pp. 31 - 36
• Main Authors: Qiu, Mei, Ding, Liang-Liang, Zhan, Ze-Lin, Liu, Shu-Yan
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2021; Springer Nature B.V
• Subjects: Apnea; Asthma; Chronic obstructive pulmonary disease; Diabetes; Edema; Endocrinology; Glucose transporter; Humanities and Social Sciences; Hypertension; Internal Medicine; Lung diseases; Medicine; Medicine & Public Health; Meta- Analysis; multidisciplinary; Na+/glucose cotransporter; Obstructive lung disease; Placebos; Pulmonary hypertension; Science; Sleep; Sleep apnea; Sleep disorders; Trends; ILD; Sleep apnoea syndrome; ARDS; SGLT2 inhibitors; Asthma; COPD
• ISSN: 1355-008X; 1559-0100
• DOI: 10.1007/s12020-021-02644-x

Purpose The impact of use of sodium-glucose transporter 2 (SGLT2) inhibitors on occurrence of various kinds of respiratory disorders has not been established. We aimed at evaluating the relationship between use of SGLT2 inhibitors and occurrence of 9 kinds of noninfectious respiratory disorders. Methods Large randomized controlled trials (RCTs) of SGLT2 inhibitors were included in this study. We conducted fixed-effects meta-analysis to synthesize risk ratios (RRs) and 95% confidence intervals (CIs). We did subgroup analysis respectively stratified by type of underlying diseases and type of SGLT2 inhibitors. Results Nine Large RCTs were included for analysis. Compared with placebo, SGLT2 inhibitors significantly reduced the occurrence of overall respiratory disorders (RR 0.75, 95% CI 0.62–0.91), acute pulmonary oedema (RR 0.51, 95% CI 0.29–0.88), asthma (RR 0.57, 95% CI 0.33–0.995), and sleep apnoea syndrome (RR 0.35, 95% CI 0.12–0.99). SGLT2 inhibitors showed the reduced trends in the risks of chronic obstructive pulmonary disease (COPD) (RR 0.79, 95% CI 0.61–1.02; P  = 0.073) and pulmonary hypertension (RR 0.43, 95% CI 0.16–1.17; P  = 0.098). SGLT2 inhibitors had no significant effects on three other respiratory disorders. These effects exhibited by SGLT2 inhibitors were consistent across different underlying diseases ( P subgroup ≥0.209) and different SGLT2 inhibitors ( P subgroup ≥0.192). Conclusions SGLT2 inhibitors can significantly reduce the occurrence of acute pulmonary oedema, asthma, and sleep apnoea syndrome; and produce the reduced trends in the risks of COPD and pulmonary hypertension. These findings will prompt further investigation on SGLT2 inhibitors for primary and secondary prevention of various respiratory disorders.