The role of Sodium-Glucose Transporter-2 Inhibitors (SGLT-2i) in preventing chronic obstructive disease exacerbation in patients with diabetes and COPD: An electronic health database analysis

Jul 19, 2024Heart & lung : the journal of critical care

SGLT-2 Inhibitors and Their Role in Preventing Flare-Ups in People with Diabetes and COPD

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Abstract

The incidence of COPD exacerbation was significantly lower in patients on SGLT-2i medications at 3.16% compared to 18.3% in those not on these medications.

SGLT-2i medication use was linked to a lower incidence of severe COPD exacerbations requiring hospitalization (1.2% vs 5.04%).
There was a non-significant trend suggesting reduced rates of ICU admissions and intubation among SGLT-2i users (0.07% vs 3.4%; 0 vs 0.04%).
The reduced incidence of COPD exacerbations was observed regardless of how well diabetes was controlled.

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BACKGROUND: Sodium Glucose Transporter 2 inhibitor (SGLT-2i) medications reduce inflammation, improve glycemic control, and impart weight loss, all of which may play a role in chronic obstructive pulmonary disease (COPD) pathophysiology.

OBJECTIVES: The primary objective of our study was to explore the incidence of COPD exacerbation in patients with diabetes and COPD on SGLT-2i medications. The secondary objective was to assess the impact of SGLT-2i medications on COPD exacerbations needing hospitalization, ICU admission, and mechanical ventilation.

METHODS: This was a retrospective cohort analysis of COPD patients with diabetes enrolled in the COPD registry at a Mid-west Tertiary care teaching hospital from January 1, 2022, to December 31, 2022. We used Slicer-Dicer, a self-service cohort exploration tool embedded in EPIC for data extraction.

RESULTS: We had 31,411 patients registered with the COPD registry during the study period. Of these, 18,713 had diabetes, and 1295 patients were on SGLT-2i medication. The incidence of COPD exacerbation, including severe COPD exacerbation needing hospitalization, was significantly lower in the SGLT-2i medication group (3.16% vs 18.3%, p < 0.05; 1.2% vs 5.04%, p < 0.05). Also, there was a non-significant trend suggesting that the incidence of COPD exacerbation needing intensive care unit admission and intubation was lower in the SGLT-2i medication group (0.07% vs 3.4%; 0 vs 0.04%). SGLT-2i medication use was associated with reduced incidence of COPD exacerbation irrespective of underlying control of diabetes.

CONCLUSIONS: Our study suggests possible role of SGLT-2i in preventing COPD exacerbation. Randomized trials are needed in the future to confirm or refute these findings.

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The role of Sodium-Glucose Transporter-2 Inhibitors (SGLT-2i) in preventing chronic obstructive disease exacerbation in patients with diabetes and COPD: An electronic health database analysis

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