Safety of SGLT-2 inhibitors in patients with glycogen storage disease type Ib and their efficacy in treating disease-associated digestive symptoms and disorders
Abstract
Background/objectives: Employing rigorous epidemiological approaches, we performed a systematic evaluation of Sodium Glucose Cotransporter-2 (SGLT-2) inhibitors for managing digestive system disorders and symptoms associated with Glycogen Storage Disease Type Ib (GSD Ib).
Methods: Electronic searches were conducted in three databases, with the latest update on 27 October 2025 (PROSPERO reference: CRD420251021881). Two reviewers independently screened records by title and abstract for full-text review. Eligible studies meeting the predefined criteria were assessed for quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for observational studies and the Methodological Index for Non-Randomized Studies (MINORS) for clinical trials, followed by data extraction.
Results: Meta-analysis or descriptive synthesis was performed for six common GSD Ib-related digestive symptoms. Multiple studies reported improvement in abnormal gastrointestinal patterns following SGLT-2 inhibitor therapy. Meta-analysis further demonstrated symptomatic relief in moderate-to-severe IBD, recurrent oral mucosal lesions, and anemia, with pooled remission rates (95% CI) under the two models being: 81.1% (68.4%-89.5%) and 85.3% (63.6%-99.2%) for IBD; 81.5% (73.6%-87.4%) and 83.5% (75.7%-90.3%) for oral lesions; and 60.5% (52.6%-68.0%) and 63.8% (48.0%-78.3%) for anemia. Regarding safety, hypoglycemia was the most frequently reported adverse event, followed by urinary tract and genital…
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