Protective Benefits of SGLT2 Inhibitors and Lupus Nephritis Save

A multicenter cohort study of systemic lupus erythematosus (SLE) patients with type 2 diabetes (NIDDM) has shown the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors associated with a significantly reduced risk of lupus nephritis, dialysis, kidney transplant, heart failure, and all-cause mortality compared with no SGLT2i use.

This multicenter cohort study used EHr coded data from US Collaborative Network of the TriNetX clinical data platform to compare those taking vs not tking SGLT2i with 1:1 propensity score matching. Outcomes reported included 5-year adjusted hazard ratios (AHRs) for lupus nephritis, dialysis, kidney transplant, heart failure, and mortality.

From a total of 31 790 patients, the propensity matched 1775 matched pairs of SGLT2i users and nonusers (N = 3550). The patients had a mean age of 57 years, and 85% were women. 

SGLT2i use significantly lowered the risk of: 

• lupus nephritis (AHR, 0.55; 95% CI, 0.40-0.77)
• dialysis (AHR, 0.29; 95% CI, 0.17-0.48)
• kidney transplant (AHR, 0.14; 95% CI, 0.03-0.62)
• heart failure (AHR, 0.65; 95% CI, 0.53-0.78)
• all-cause mortality (AHR, 0.35; 95% CI, 0.26-0.47) 

SGLT2i use isn SLE is has both nephroprotective and cardioprotective benefits.