Abstract：
Sodium glucose co-transporter 2 (SGLT2) inhibitors are used for the treatment of diabetes and for their cardiovascular and kidney benefits in patients with or without diabetes. Use in solid organ transplant recipients is controversial because transplant recipients were excluded from the major clinical trials assessing SGLT2 inhibitors. The goal of this review was to assess the available literature regarding the use of SGLT2 inhibitors in solid organ transplant recipients. A PubMed search was conducted for studies published in English through December 31, 2023. Studies were excluded if they were meta-analyses, review articles, commentaries, single case reports, or in vitro studies, or did not involve the use of SGLT2 inhibitors in solid organ transplant recipients with a diabetic, cardiovascular, or kidney outcome being assessed. In the final review, 20 studies were included: kidney (n = 15), heart (n = 4), and liver/lung/kidney (n = 1) transplant recipients. SGLT2 inhibitors had similar A1c reduction efficacy and were found to be weight neutral with possible weight reduction effects. Cardiovascular and kidney outcomes were not adequately assessed in the available studies. Adverse effects were reported to occur at a similar rate in transplant recipients compared to the general population. SGLT2 inhibitors were initiated ≥1-year post-transplant in most transplant recipients included in these studies. The overall safety and antihyperglycemic efficacy of SGLT2 inhibitors in kidney and heart transplant recipients is similar to the general population. Data assessing SGLT2 inhibitors use in solid organ transplant recipients for longer durations are needed.
摘要：
钠葡萄糖共转运蛋白2（SGLT2）抑制剂用于治疗糖尿病，以及在患有或不患有糖尿病的患者中的心血管和肾脏益处。在实体器官移植受者中的使用存在争议，因为移植受者被排除在评估SGLT2抑制剂的主要临床试验之外。这篇综述的目的是评估有关SGLT2抑制剂在实体器官移植受者中使用的现有文献。PubMed搜索了截至2023年12月31日以英文发表的研究。如果是荟萃分析，研究被排除在外，评论文章,评论,单病例报告,或体外研究，或不涉及在患有糖尿病的实体器官移植受者中使用SGLT2抑制剂，心血管,或正在评估的肾脏结果。在最后的审查中,包括20项研究：肾脏（n=15），心脏（n=4），和肝/肺/肾（n=1）移植受者。SGLT2抑制剂具有类似的A1c降低功效,并且发现具有可能的减重效果的重量中性。在现有的研究中，心血管和肾脏结局没有得到充分评估。据报道，与普通人群相比，移植受者的不良反应发生率相似。这些研究中包括的大多数移植受者在移植后≥1年开始使用SGLT2抑制剂。SGLT2抑制剂在肾脏和心脏移植受者中的总体安全性和抗高血糖功效与普通人群相似。需要评估SGLT2抑制剂在实体器官移植受者中使用更长持续时间的数据。
