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The Efficacy and Safety of Sodium Glucose Cotransporter 2 Inhibitors in the Treatment of Syndrome of Inappropriate Antidiuresis: A Systematic Review

Zuo Q, Liang S, Wang Y, Sun L, Chen S, Pan H

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2026

Abstract

Objective: To evaluate the efficacy and safety of sodium glucose cotransporter 2 (SGLT2) inhibitors in the treatment of syndrome of inappropriate antidiuresis (SIAD) in randomized controlled trials.

Methods: We conducted a literature search in PubMed and Embase. Reference lists of initially included reports were screened to find more relevant studies. Retrieved records were reviewed by 2 authors independently and discrepancies were resolved through discussion. Data were extracted from eligible studies, including the basic characteristics of study, the efficacy outcomes and secondary outcomes. The risk of bias of the eligible studies was assessed by the 2 authors independently based on Cochrane risk of bias tool for randomized trials (RoB 2).

Results: Two randomized controlled trials were included in the systematic review. Five relevant case reports were identified and summarized in a table. The SGLT2 inhibitor empagliflozin was found to be effective in increasing serum sodium concentration in patients with SIAD and was generally well tolerated in included studies. Furthermore, the effect of SGLT2 inhibitor in increasing serum sodium concentration was moderate.

Conclusion: To the best of our knowledge, this is the first systematic review to summarize the efficacy and safety of SGLT2 inhibitors in the treatment of SIAD. However, larger-scale studies need to be conducted in the future to validate the findings.

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