| Autor: |
Gorgojo-Martínez JJ; Department of Endocrinology and Nutrition, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain., Górriz JL; Department of Nephrology, Valencia Clinic University Hospital, Instituto de Investigación Sanitaria (INCLIVA), Universitat de València, 46010 Valencia, Spain., Cebrián-Cuenca A; Health Centre Casco Antiguo Cartagena, Primary Care Research Group, Biomedical Research Institute of Murcia (IMIB), 30201 Cartagena, Murcia, Spain., Castro Conde A; Department of Cardiology, University Hospital La Paz, IdiPAZ, Biomedical Research Center-Cardiovascular Diseases (CIBERCV-ISCIII), 28046 Madrid, Spain., Velasco Arribas M; Department of Infectious Diseases, Research Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain. |
| Abstrakt: |
Background: SGLT-2 inhibitors (SGLT-2is) are considered to be a first-line treatment for common conditions like type 2 diabetes, chronic kidney disease, and heart failure due to their proven ability to reduce cardiovascular and renal morbidity and mortality. Despite these benefits, SGLT-2is are associated with certain adverse effects (AEs), particularly genitourinary (GU) events, which can lead to treatment discontinuation in some patients. Preventing these AEs is essential for maintaining the cardiorenal benefits of SGLT-2is. Methods: A multidisciplinary panel of experts from various medical specialties reviewed the best available evidence on GU AEs associated with SGLT-2i therapy. The panel focused on the prevention and management of genital mycotic infections, urinary tract infections, and lower urinary tract symptoms in both the general population and high-risk groups, such as renal and cardiac transplant recipients. Results: The panel found that permanent discontinuation of SGLT-2is results in a rapid loss of cardiorenal benefits. Preventive strategies, including identifying high-risk patients before initiating therapy, are critical for minimizing GU AEs. Clinical trials show that most GU infections linked to SGLT-2i therapy are mild to moderate in severity and typically respond to standard antimicrobial treatment, without the need for discontinuation. Conclusions: Routine discontinuation of SGLT-2is due to GU AEs is not recommended. Therapy should be resumed as soon as possible, unless severe or persistent conditions contraindicate their use, in order to preserve the significant benefits of SGLT-2is in reducing cardiovascular and renal events. |
