Sodium-Glucose Cotransporter 2 Inhibitors in Lupus Nephritis and ANCA-Associated Vasculitis: Unmet Needs to be Addressed
Abstract
Background: Current treatment of severe autoimmune glomerulonephritis such as lupus nephritis (LN) and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) relies primarily on immunosuppression to reduce kidney inflammation and chronic damage. However, many patients exhibit persistent proteinuria despite treatment, which serves as a prognostic biomarker for long-term outcomes. The residual proteinuria after 12 months might reflect hyperfiltration in remaining nephrons due to chronic damage rather than active inflammation, contributing to progressive kidney function deterioration.
Summary: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are established drugs used to minimize chronic kidney disease (CKD) progression, demonstrating benefits beyond glycemic control. These medications reduce intraglomerular pressure, decrease albuminuria, minimize tubular workload, and exhibit anti-inflammatory properties through various mechanisms which ultimately reduce hard cardiovascular and kidney-related endpoints in large clinical trials. However, their potential role in managing LN and AAV remains unexplored because such individuals were systematically excluded from the landmark clinical trials due to concerns about immunosuppression and infection risks.
Key messages: In this review, we describe the mechanisms underlying SGLT2i effectiveness, explore the rationale and existing evidence gaps regarding their application and optimal timing for SGLT2i initiation in LN…
Read the paper
Related studies
- Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa
- Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis
- A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study
- Post‑COVID‑19 Syndrome in Outpatients: a Cohort Study
- Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients
- Electroacupuncture for Painful Diabetic Peripheral Neuropathy: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.