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Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Refractory Cirrhotic Ascites and Diabetes: Scoping Review Protocol

Laeeq T, Kamal AM, Kasi ABU, Shabbar Banatwala UES, Baloch A, Sagaribay R, Goel V, Singh A et al.

JMIR research protocols, 2026

Abstract

Background: Hepatic cirrhosis is a complex condition leading to multiple complications, including ascites, hepatic encephalopathy, bleeding varices, and eventually liver failure. Patients with diabetes mellitus or insulin resistance are more likely to fail treatment, leading to the worsening of hepatic fibrosis. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new class of drugs with the potential for use in cirrhotic ascites. This scoping review will focus on the response of the addition of SGLT2 inhibitors (SGLT2i) on refractory ascites.

Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to the response of the addition of SGLT2i on refractory ascites in patients with diabetes mellitus or insulin resistance.

Methods: A comprehensive literature search will be conducted across five databases using variations of the keywords "Sodium-glucose Cotransporter-2 Inhibitors" and "ascites" to identify original studies published from inception through December 2023. The search will be limited to English-language human studies evaluating the efficacy of SGLT2 inhibitors, excluding studies focused on other drugs or conducted in animal models. This review will include studies involving patients over 21 years of age with cirrhotic ascites and will exclude studies involving noncirrhotic causes. Only studies containing original patient data will be considered, regardless of health care setting, to ensure clinical relevance and…

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