Role of SGLT2 inhibitors in cancer therapy-related cardiac dysfunction (CTRCD) in adults: systematic review and meta-analysis: SGLT2 inhibitors and CTRCD.

Our primary objective is to evaluate the role of SGLT2 inhibitors in the protection against cancer therapy-related cardiac dysfunction (CTRCD) in adults with both cancer and type 2 diabetes mellitus. This is a systematic review and meta-analysis. A comprehensive search was conducted in five databases for studies published up to January 5th, 2025, using a PECO strategy. Seven studies were identified for quantitative analysis and included in our meta-analysis. Primary studies evaluating the use of SGLT2 inhibitors for the protection against CTRCD were included, specifically those in which CTRCD developed after chemotherapy and without a prior history of heart failure as the primary outcome. In the meta-analysis of 10,460 patients who received SGLT2i versus 12,815 in the control group, we found that SGLT2i use was associated with a 48% reduction in the risk of developing CTRCD (RR 0.52; 95% CI: 0.30-0.90; I2: 31%). Additionally, there was a reduction in both all-cause mortality (RR 0.44; 95% CI: 0.31-0.63; I2: 90%) and acute kidney injury (AKI) as a complication (RR 0.61; 95% CI: 0.49-0.77; I2: 0%). The use of SGLT2i in patients with cancer and T2DM may reduce the risk of CTRCD, mortality, and AKI.