Cardiometabolic protective mechanisms and efficacy of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) in SLE

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ID: 318629
2026
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Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with substantial cardiovascular, metabolic, and renal morbidity. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially developed for type 2 diabetes (T2D), have demonstrated beneficial effects beyond glucose lowering, including improvements in metabolic, cardiovascular, and renal outcomes. These effects span multiple domains, including glycemic control, body weight and blood pressure reduction, heart failure and atherosclerotic cardiovascular disease outcomes, kidney function preservation, and potential immunomodulatory pathways. This narrative review summarizes the metabolic, cardiovascular, renal, and immunomodulatory effects of SGLT2i relevant to SLE. Evidence from the general population supports cardiometabolic and renal benefits, while observational studies and early-phase trials in SLE and lupus nephritis (LN) suggest potential benefits in selected patients. However, SLE-specific evidence remains limited, and important gaps persist regarding efficacy and safety in active disease. Further studies are needed to define the role of SGLT2i in SLE.
Reference Key
openalex_W7165754145 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Youngmin Kim, April Jorge, Brittany N Weber, Karen H Costenbader
Journal Lara D. Veeken
Year 2026
DOI
10.1093/rheumatology/keag290
URL
https://doi.org/10.1093/rheumatology/keag290
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