OR27-6 Effects of the SGLT2-Inhibitor Empagliflozin in Patients With Chronic Syndrome of Inadequate Antidiuresis (SIAD) - Results of a Double-Blind, Randomized, Placebo-Controlled, Crossover Trial
Abstract
Abstract Introduction Hyponatremia is the most common electrolyte disorder and the syndrome of inappropriate antidiuresis (SIAD) is one of its main causes. However, treatment options for chronic SIAD-induced hyponatremia are inadequate. This is problematic because hyponatremia has been associated with neurocognitive deficits, although there is little data on its reversibility.We previously showed that the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin is a promising short-term treatment option for hospitalized patients with SIAD-induced hyponatremia, promoting osmotic diuresis via urinary glucose excretion. However, there are no data on long-term treatment in outpatients nor its effect on neurocognitive function. Material and Methods In this double-blind, randomized, placebo-controlled, crossover trial we compared 4-week treatment with empagliflozin 25mg/day to placebo in addition to fluid restriction of ≤1.5L/24h in outpatients with chronic SIAD-induced hyponatremia (serum sodium <135mmol/L). At baseline and after both treatment cycles, patients underwent neurocognitive testing (Montreal Cognitive Assessment (MoCA) test). There was a 2-week wash-out period between the two treatment cycles, and a follow-up visit was scheduled 30 days after completion of the treatment phase.The primary endpoint was the difference in serum sodium levels (mmol/L) after 4 weeks of treatment with empagliflozin or placebo, calculated using a linear mixed-effects model. Results 14…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 14 participants or records.
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