Sotagliflozin shortens hospital stay, improves survival in T2D patients with worsening heart failure

Treatment with sotagliflozin in hospitalized patients with type 2 diabetes (T2D) leads to an increase in the number of days alive and out of the hospital (DAOH), a metric that may provide an additional patient-centred outcome to capture the totality of disease burden, reports a study.

A total of 1,222 patients with T2D and reduced or preserved ejection fraction who were recently hospitalized for worsening heart failure at 306 sites in 32 countries were randomized to receive 200-mg sotagliflozin once daily (with a possible dose increase to 400 mg) or matching placebo. DAOH and its converse (days dead and in the hospital) were analysed using prespecified Poisson regression models.

The proportion of patients hospitalized at least once was comparable between sotagliflozin and placebo groups (38.5 percent vs 41.4 percent), but fewer patients on sotagliflozin were hospitalized more than once (16.3 percent vs 22.1 percent) or had died (64 vs 76).

Most notably, the rate of DAOH was 3-percent higher in the sotagliflozin than in the placebo group (rate ratio [RR], 1.03, 95 percent confidence interval [CI], 1.00–1.06; p=0.027). The difference was driven by a decrease in the rate of days dead (RR, 0.71, 95 percent CI, 0.52–0.99; p=0.041) rather than by reduction in the rate of days hospitalized for any cause.

In addition, patients on sotagliflozin were alive and out of the hospital for 2.9 more days than those on placebo (91.8 vs 88.9 days) for every 100 days of follow-up. Such difference showed a 2.6-day difference in days dead (6.3 vs 8.9 days) and a 0.3-day difference in days in the hospital (1.9 vs 2.2 days).

“Future studies are needed to quantify the consequences of increasing DAOH in terms of health economics and patient quality of life,” the investigators said.