SGLT2i may improve COPD outcomes in T2D patients

In the treatment of patients with type 2 diabetes mellitus (T2DM) and comorbid chronic obstructive pulmonary disease (COPD), the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) appears to minimize COPD-related emergency room (ER) visits and hospitalizations, as shown in a study.

For the study, researchers recruited adults with T2DM and COPD who were treated in a primary care clinic. Of the 220 patients screened, 94 met the inclusion criteria and were included. Twenty patients (21.3 percent) were using SGLT2i at admission and 74 (78.7 percent) were not (control).

Demographic information and data on outcomes such as emergency room (ER) visits, hospitalizations secondary to COPD exacerbation were collected over the period of 4 years, as well as time to hospitalization and ER visits. Analysis was performed using Cox regression and Kaplan-Meier models.

Patient characteristics at baseline were well-matched between the SGLT2i and control groups. Compared with nonuse, SGLT2i use was associated with significantly fewer ER visits (70 percent vs 97.3 percent; p=0.001) and hospitalizations (55 percent vs 87.8 percent; p=0.001).

Of note, SGLT2i use reduced the risk of hospitalization by more than 80 percent (adjusted hazard ratio [aHR], 0.156, 95 percent confidence interval [CI], 0.073–0.331) and the risk of ER visits by more than 70 percent (aHR, 0.232, 95 percent CI, 0.118–0.453).

According to the researchers, this protective effect of SGLT2i on COPD could be explained by reduced systemic proinflammatory markers and increased anti-inflammatory markers via inhibition of Node like receptor protein 3 (NLRP3) inflammasome activation in multiple tissues, including the lungs.