Efficacy and safety of specific treatment combined with SGLT2-i in pulmonary hypertension

Background/aims Specific treatment of pulmonary hypertension (PH) can improve right heart function and exercise endurance, but many adverse reactions caused by specific drugs should not be ignored. Existing basic and clinical studies suggest that sodium-glucose cotransporter 2 inhibitors (SGLT2-i) may be useful in patients with PH and improve their prognosis to some extent. Exploring the efficacy and safety of specific treatments combined with dapagliflozin (DAPA) in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and to provide a clinical basis for new therapeutic possibilities for pulmonary vascular disease. Methods This study is a prospective, exploratory study that includes patients who attended the First Hospital of Jilin University from 2022 to 2024, divided into DAPA group and historical control group. The clinical data of the patients before and after treatment were compared. The primary endpoint event is defined as the improvement in 6 min walk distance (6MWD). Adverse events were defined as hemoglobin decreased, liver and kidney damage, urinary tract infection, severe hypoglycemia and hypotension, and ionic disturbances. Results 73 patients were finally included in this study, including 28 in the DAPA group and 45 in the control group, with an average age of 44.99 ± 14.14 years. After 3 months of treatment, a comparison was made between the two groups, there was no statistically significant difference in 6MWD ( P > 0.05). Compared with before treatment, the hemoglobin (146.80 ± 24.94 vs. 139.78 ± 23.57, P < 0.05) in the control group decreased significantly after treatment, while the hemoglobin in the DAPA group (155.25 ± 31.30 vs. 154.04 ± 31.93, P > 0.05) showed no significant change. Conclusions Studies have shown that the application of specific drugs can significantly improve the right heart function and activity endurance of patients with PAH and CTEPH. When combined with DAPA treatment, no significant additional benefits have been observed. However, DAPA treatment can alleviate the decrease in hemoglobin caused by the disease or drug reasons in patients with PH, and reduce the side effects caused by specific drugs.