The Role of Sodium-Glucose Co-Transporter-2 (SGLT-2) Inhibitors in Treating Lupus Nephritis: A Systematic Review.

Systemic lupus erythematosus (SLE) is a prevalent autoimmune condition worldwide resulting from the loss of tolerance against self-antigens. The constitutional symptoms of SLE are well-known, including fatigue, fever, myalgia, weight loss, arthralgia, arthritis, malar rash, and photosensitivity. These symptoms often overshadow the impacts SLE can have on all body systems, with the renal system frequently impacted. Inflammation of the nephrons can progress to end-stage renal disease and renal failure if not treated effectively. Currently, the medications that are being utilized for the treatment of lupus nephritis (LN), include azathioprine, hydroxychloroquine, cyclophosphamide, belimumab, voclosporin, tacrolimus, mycophenylate, and rituximab. However, the majority of these medications are used off-label, and many come with severe side effects. With the additional benefits of anti-diabetic medications being examined outside of their original purpose, sodium-glucose co-transporter-2 (SGLT-2) inhibitors have begun to be investigated for their role in LN. To determine the impact of SGLT-2 inhibitors on LN risk and progression, a preliminary systematic review was conducted. A total of 248 articles were analyzed, with six being selected. SGLT-2 inhibitors were found to improve glomerular filtration rate (GFR), reduce proteinuria and albuminuria, and reduce the inflammatory cascade. The exploration of SGLT-2 inhibitors as a therapeutic strategy for LN represents a promising and innovative approach to managing this complex condition. SGLT-2 inhibitors show potential benefits beyond glycemic control. However, due to the novelty of this treatment and the limited studies completed, further testing is required to analyze its true effectiveness in LN.