Empagliflozin Pharmacotherapy: An Updated Overview Publisher



Z Toloughamari ZAHRA
Source: New Emirates Medical Journal Published:2024

Abstract

It has been estimated that by 2030, the number of patients with diabetes is expected to rise to 552 million. Moreover, an estimated 20 million new cancer cases were reported in 2022, and 64 million people worldwide are currently suffering from heart failure. Recently, there has been an increasing interest regarding the prescription of a drug that was approved for use in May, 2014, which is called empagliflozin. Up to now, limited data is available on the efficacy, safety, and side effects of empagliflozin against a variety of diseases, including diabetes, heart failure, and cancer. Therefore, this study aimed to gather relevant data on empagliflozin by searching electronic databases, such as Web of Science, Scopus, Pubmed, and Cochrane Library, through October 9th, 2024. One hundred thirty-eight relevant studies, including review articles, clinical trials, and case reports, were assessed. It was found that orally, once daily use of empagliflozin, in addition to the glucose-lowering effect, suppresses inflammation and improves diastolic function. Empagliflozin inhibits breast cancer stemness by inactivating transcription factors and enzyme pyruvate kinase M2 via enhanced miR-128-3p expression. By inhibiting the sodium-glucose cotransporter, the drug has a well-known safety and efficacy in patients with breast cancer, type 1 or 2 diabetes, acute septic renal injury, renal disease, and heart failure. Regarding efficacy, empagliflozin acts as an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, sodium-glucose cotransporter type 2 inhibitor, vascular resistance prevention, and albuminuria-lowering agent. A recently published observational study confirmed the efficacy and safety of empagliflozin in improving kidney function and glycemic profile and reducing cardiovascular events in diabetic patients with advanced chronic kidney disease. In addition, empagliflozin is efficient as a blood pressure-lowering agent in patients with hypertension and those at higher risk of cardiovascular disease. Furthermore, for patients with diabetes and obesity, empagliflozin reduces the progression of kidney disease and improves clinical conditions in those with high blood pressure. It has a beneficial effect on hemoglobin A1c (HbA1c), body weight, glucose variability, and total daily insulin use in people with type 1 diabetes. Itching or redness of the genital area, genital infection, hematuria, difficulty in urination, bladder pain, painful sexual intercourse, peripheral amputations, and Fournier’s gangrene (rarely informed adverse effects) are the most commonly reported side effects. Additionally, pancreatitis, bad odor, and suicide attempts were recorded in some published case reports. Further evidence-based polypharmacological benefits studies' of empagliflozin associated with its nephroprotective, cardioprotective, and glucose-lowering effects and in cancer were reported to be advantageous. © 2025 Elsevier B.V., All rights reserved.