Could renin-angiotensin-aldosterone system activation explain the amputations associated with canagliflozin? The nitric oxide hypothesis
| Autor: | Miguel Ángel Rico Corral, Luis Castilla Guerra, José Pablo Miramontes González, David Jiménez, Antonio Espino Montoro, José Manuel López Chozas |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Canagliflozin
medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism General Medicine medicine.disease Nitric oxide chemistry.chemical_compound Endocrinology chemistry Internal medicine Diabetes mellitus Renin–angiotensin system Internal Medicine Medicine business medicine.drug |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| Popis: | One of the most important reported adverse effects events of related to sodium-glucose cotransporter-2 inhibitors (SGLT2i) is lower-limb amputations. While the reasons for the increased rate of these events are still unclear, it is unlikely that an unique explanation may explain the mechanisms by which this undesired effect occurs. In the present article we propose a hypothesis based on the observation of two patients with type 2 diabetes mellitus (DM) who, after receiving dapagliflozin, experienced erectile dysfunction (ED). In both cases the ED did not improve after adding losartan but improved markedly after starting treatment with ramipril, a type 1 angiotensin-converting enzyme inhibitor (ACEi), without the need to remove dapagliflozin. In both patients the ED was evaluated using the internationally validated test IIEF-5 (International Index of Erectile Function 5 items) [1]. Alternative hormonal and pharmacological causes for ED were ruled out. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|