Metabolic effects of pioglitazone and sodium-glucose cotransporter 2 inhibitors in familial partial lipodystrophy.

OBJECTIVE

We aimed to evaluate the potential metabolic benefits of pioglitazone, a PPARG agonist, and sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with familial partial lipodystrophy (FPLD).

METHODS

This retrospective medical chart study included 38 adult patients with FPLD (18 treated with pioglitazone and 20 with SGLT2 inhibitors).

RESULTS

Treatment with pioglitazone reduced HbA1c from 8.6% (6.2-9.2) to 7.0% (5.9-8.8) at month 6 (p = 0.004) and 7.0% (6.1-8.7) at month 12 (p = 0.107). Triglycerides decreased by 25% (6-55%) at month 6 (p = 0.001) and 16% (4-44%) at month 12 (p = 0.008). A modest reduction in ALT was observed at month 12 (p= 0.046). Treatment with SGLT2 inhibitors reduced HbA1c from 8.7% (7.9-10.2) at baseline to 8.1% (7.4-9.4) at month 6 (p = 0.003) and 7.9% (7.3-8.9) at month 12 (p = 0.003). Median triglyceride levels decreased by 11% (0-33%) at month 6 (p = 0.013), while changes at month 12 were not significant. No meaningful changes were observed in weight, ALT, or AST.

CONCLUSIONS

We observed modest metabolic improvements following treatment with pioglitazone and SGLT2 inhibitors in patients with FPLD.