#3065 Effect of dapagliflozin and empagliflozin on phosphate-FGF23 homeostasis in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Abstract
Emerging clinical evidence suggest that SGLT2 inhibitors could modulate serum phosphate levels. However, the impact of these drugs on fibroblast growth factor-23 (FGF23) levels remains unclear. This systematic review and meta-analysis evaluated the impact of SGLT2 inhibitors on phosphate-FGF23 homeostasis in patients with type 2 diabetes mellitus (T2DM).
PubMed and Web of Science databases were searched using key words: “SGLT2 inhibitor”, and “FGF23” up to January 2025. A random effects model was used, with the outcome expressed as standardised mean difference (SMDs) with 95% confidence interval [CI]. Heterogeneity was quantified by I2 values. Subgroup analysis was also performed according to duration of treatment (≤ 6-, >6–24 weeks). P-value < 0.05 was considered statistically significant.
In total, four active- or placebo-controlled clinical studies involving patients with T2DM met our inclusion criteria. Among the studies included, dapagliflozin and empagliflozin were the SGLT2 inhibitors administered at a dose of 10 mg/day and the follow-up durations ranged from 3-days to 24 weeks. Overall, dapagliflozin and empagliflozin significantly increased serum phosphate levels in T2DM patients (SMD = 0.64 [0.20, 1.09], P = 0.005), consistent across duration of treatment (≤ 6-, >6–24 weeks). The meta-analysis also showed that use of SGLT2 inhibitor presented a non-significant increase in serum levels of FGF23 in T2DM patients (P = 0.54). However, discrepancies in reported FGF23…
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