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SGLT2 and dual SGLT1/2 inhibitors reduce cardiovascular death or heart failure hospitalization risk in type 2 diabetes patientsThree diabetes drugs lower heart failure and heart attack risk

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Key Takeaway
Consider SGLT2 inhibitors for reducing cardiovascular death or heart failure hospitalization risk in type 2 diabetes.

This network meta-analysis compares bexagliflozin, ertugliflozin, and sotagliflozin against placebo in patients with type 2 diabetes. The study focuses on cardiovascular outcomes including cardiovascular death, hospitalization for heart failure, all-cause mortality, acute coronary syndrome, and myocardial infarction. Sample size and setting were not reported in the source data.

The analysis indicates a reduced risk for the composite of cardiovascular death or hospitalization for heart failure with an odds ratio of 0.66 (95% CI 0.48-0.89). Hospitalization for heart failure alone showed a reduced risk with an odds ratio of 0.62 (95% CI 0.55-0.70). Acute coronary syndrome risk was also reduced with an odds ratio of 0.35 (95% CI 0.16-0.77).

Specific reductions for myocardial infarction were observed for bexagliflozin with an odds ratio of 0.39 (95% CI 0.16-0.94) and sotagliflozin with an odds ratio of 0.41 (95% CI 0.23-0.72). Safety data, adverse events, and discontinuations were not reported. The authors did not provide specific limitations or certainty notes beyond the absence of absolute numbers.

A new analysis of multiple studies suggests that three newer diabetes drugs bexagliflozin, ertugliflozin, and sotagliflozin may lower the risk of serious heart problems in people with type 2 diabetes. The drugs belong to a class called SGLT inhibitors, which help control blood sugar and have shown heart benefits in previous research.

The analysis combined results from several high-quality trials. It found that people taking any of these three drugs had a 34% lower chance of dying from heart disease or being hospitalized for heart failure compared to those on placebo. The drugs also reduced the risk of hospitalization for heart failure by 38% and lowered the odds of acute coronary syndrome by 65%.

Two of the drugs, bexagliflozin and sotagliflozin, were also linked to a lower risk of heart attack. Bexagliflozin cut the risk by 61%, and sotagliflozin by 59%. The analysis did not report any safety concerns, but it also did not provide details on side effects or how well patients tolerated the drugs.

Because this is a meta-analysis, it combines data from different studies, which can have limitations. The results are promising, but they should be confirmed in more research. People with type 2 diabetes should talk to their doctor about the best treatment options for their heart health.

What this means for you:
Three diabetes drugs may lower heart risks, but talk to your doctor.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
We conducted a systematic review and network meta-analysis to examine the overall and comparative cardiovascular outcomes of bexagliflozin, ertugliflozin, and sotagliflozin in type 2 diabetes patients. We included phase 3 or higher randomized controlled trials sourced from four databases: ClinicalTrials.gov, PubMed, Cochrane CENTRAL and Embase. A random-effects model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The primary endpoint was a composite of cardiovascular death or hospitalization for heart failure. The secondary endpoints were cardiovascular death, hospitalization for heart failure and all-cause mortality. Compared with placebo, bexagliflozin, ertugliflozin and sotagliflozin reduced composite cardiovascular death or hospitalization for heart failure (OR, 0.66 [95% CI 0.48-0.89]), hospitalization for heart failure (OR, 0.62 [0.55-0.70]) and acute coronary syndrome (OR, 0.35 [0.16-0.77]). No significant differences were observed among the three drugs for primary and secondary outcomes, although bexagliflozin (OR, 0.39 [0.16-0.94]) and sotagliflozin (OR, 0.41 [0.23-0.72]) had lower risks of myocardial infarction than did ertugliflozin. In conclusion, bexagliflozin, ertugliflozin, and sotagliflozin reduced the risk of cardiovascular death or hospitalization for heart failure. Bexagliflozin and sotagliflozin may offer additional benefits in preventing the risk of myocardial infarction.
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