New Study Highlights Benefits of Sotagliflozin in Type 1 Diabetes with CKD - EMJ

New Study Highlights Benefits of Sotagliflozin in Type 1 Diabetes with CKD

A RECENT analysis has revealed that sotagliflozin, a dual sodium-glucose cotransporter 1 and 2 inhibitor, offers significant benefits for individuals with Type 1 diabetes and chronic kidney disease (CKD) when added to insulin therapy. Findings indicate improved glycaemic control and reductions in body weight and systolic blood pressure (BP) without a marked increase in severe hypoglycaemia or diabetic ketoacidosis (DKA).

The study pooled data from three trials (two 52-week inTandem studies and one 24-week inTandem 3 study) encompassing over 3,000 participants. Among these, 465 participants were identified with CKD.

Sotagliflozin, administered at doses of 200 mg or 400 mg daily, was found to significantly reduce glycated haemoglobin (HbA1c) levels at week 24. In the CKD subgroup, placebo-adjusted reductions in HbA1c were recorded as -0.4% (200 mg) and -0.3% (400 mg). Similarly, the treatment yielded substantial decreases in body weight and systolic BP, although BP improvements were less pronounced in CKD patients compared to those without CKD.

Safety data highlighted a reduced incidence of severe hypoglycaemia in the CKD subgroup, with rates of 7% and 4% for the 200 mg and 400 mg doses, respectively, compared to 17% in the placebo group. The risk of DKA, a potential complication, remained low overall but was slightly higher with sotagliflozin compared to placebo, particularly at higher doses.

The study underscores the potential of sotagliflozin to enhance diabetes management in patients with CKD. By improving glycaemic control and reducing cardiovascular risk factors like weight and BP, the treatment could help mitigate the progression of CKD.

However, experts caution that while the overall safety profile is favourable, the risk of DKA requires careful monitoring, particularly in higher-dose regimens.

These findings position sotagliflozin as a promising adjunct therapy for type 1 diabetes patients with CKD. Further studies could provide deeper insights into long-term outcomes and strategies for optimising treatment.

This study highlights the growing importance of tailored approaches to managing diabetes in complex cases, offering hope for improved quality of life and clinical outcomes.

Victoria Antoniou, EMJ

Reference

Sridhar VS et al. Efficacy and safety of sotagliflozin in patients with Type 1 diabetes and CKD. J Am Soc Hepatol. 2025;DOI:10.1681/ASN.0000000540.

 

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