Sotagliflozin, a medication for type 2 diabetes, effectively improves HbA1c levels and reduces body weight. However, the degree of benefit is directly tied to kidney function, with a higher dose (400 mg) showing greater efficacy in patients with impaired kidney function, according to a new meta-analysis. Belinda Hardin,PharmD,presented findings at the American Association of Clinical Endocrinology Annual Scientific and Clinical Conference,underscoring the importance of considering kidney health when prescribing this SGLT1 and SGLT2 inhibitor. Notably, in those with the most reduced kidney function, the drug’s impact diminishes. News Directory 3 keeps you informed on the latest medical breakthroughs. Discover what’s next for diabetes management and kidney health.
Sotagliflozin Shows Benefits for Type 2 Diabetes, Impacted by Kidney Function
Updated June 06, 2025
ORLANDO — A new meta-analysis reveals that sotagliflozin can improve both HbA1c levels and body weight in individuals with type 2 diabetes.However, researchers found that the degree of betterment is linked to the patient’s kidney function.
The research also indicated that a 400 mg dose of sotagliflozin (Inpefa, lexicon) was more effective than a 200 mg dose in patients with impaired kidney function, when compared to a placebo.
Sotagliflozin 400 mg provides greater improvements in HbA1c and body weight than then 200 mg dose for adults with impaired kidney function. image: Adobe Stock
Belinda Hardin, PharmD, senior director at Lexicon Pharmaceuticals, presented the findings at the American Association of Clinical Endocrinology Annual Scientific and Clinical Conference. The patient-level meta-analysis included data from eight trials comparing sotagliflozin to a placebo.
“As many as 40% of patients with diabetes will develop some type of kidney impairment,” Hardin said. She noted that sotagliflozin, an inhibitor of both SGLT1 and SGLT2, has demonstrated the ability to reduce heart failure-related outcomes. The study aimed to determine if sotagliflozin could also reduce HbA1c levels, similar to other SGLT2 inhibitors.
The study involved 3,896 patients, with an average age of 63.1 years. of the participants, 45.5% were women and 60.7% had obesity.Researchers divided them into three groups based on estimated glomerular filtration rate (eGFR): 60 mL/min/1.73 m2 or higher; 30 mL/min/1.73 m2 to less than 60 mL/min/1.73 m2; or less than 30 mL/min/1.73 m2. The primary focus was on changes in HbA1c and body weight compared to the placebo.
The most significant treatment effect was observed in patients with an eGFR of 60 mL/min/1.73 m2 or higher. In this group, there was no notable difference between the 200 mg and 400 mg doses of sotagliflozin, according to the researchers.
Hardin noted that for patients with eGFR between 30 mL/min/1.73 m2 and 60 mL/min/1.73 m2, the 400 mg dose of sotagliflozin maintained efficacy for both HbA1c and body weight. However,the 200 mg dose showed a less consistent impact on HbA1c.
In patients with eGFR less than 30 mL/min/1.73 m2,the ability of sotagliflozin to reduce HbA1c and body weight was diminished,with the 200 mg dose potentially favoring the placebo,Hardin said.
“Both 200 mg and 400 mg [sotagliflozin] do significantly improve glycemic control as persistent by HbA1c and significantly improve body weight compared to placebo,” she said. “However, 400 mg actually provides the greatest improvement in the presence of moderate to severe renal impairment. Although there are benefits, that degree of improvement is, in fact, attenuated in those patients, especially those with the most-reduced kidney function. This is an vital finding [which will] help inform clinical decision-making.”
What’s next
The findings suggest that while sotagliflozin can be a valuable tool in managing type 2 diabetes, clinicians should consider kidney function when determining the appropriate dosage and treatment strategy. Further research may explore the specific mechanisms behind the varying effectiveness of sotagliflozin in patients with different levels of kidney function.
