Faculty mentor/PI email address
Yschneid@virtua.org
Is your research Teaching and Learning based?
1
Keywords
SGLT2, Cirrhosis, Hepatic Encephalopathy, Renal Failure, Mortality
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: SGLT2 inhibitors improve cardiovascular and renal outcomes in type 2 diabetes mellitus (T2DM), but their safety in cirrhosis remains uncertain given risks of volume depletion, infection, and decompensation. We evaluated the association between SGLT2 inhibitor use and hepatic decompensation and healthcare utilization in cirrhotic patients with T2DM.
Methods: A retrospective cohort study was performed using the TriNetX multicenter electronic health record network. Adults with cirrhosis and T2DM between 2018–2024 were classified as SGLT2 inhibitor-treated versus untreated. Propensity score matching (1:1) yielded 23,234 patients per group. Primary outcomes included new ascites, hepatic encephalopathy (HE), ED visits/inpatient admissions, and all-cause mortality. Secondary outcomes included clinical bleeding, infection, renal failure, and incident CKD. Risk ratios (RR) with 95% confidence intervals were estimated.
Results: SGLT2-treated patients had significantly lower risks of new ascites (6.9% vs. 12.4%; RR 0.56) and HE (3.7% vs. 5.3%; RR 0.69). ED/inpatient admissions were reduced (43.7% vs. 51.1%; RR 0.85), as was all-cause mortality (8.4% vs. 20.0%; RR 0.42). Secondary outcomes consistently favored SGLT2 therapy, including lower rates of clinical bleeding (8.2% vs. 11.2%; RR 0.73), infection (18.8% vs. 27.6%; RR 0.68), renal failure (10.2% vs. 14.6%; RR 0.70), and incident CKD (8.8% vs. 10.1%; RR 0.87).
Conclusions: In cirrhotic patients with T2DM, SGLT2 inhibitor use was associated with substantially lower risks of hepatic decompensation, hospitalization, mortality, and renal complications. These findings suggest potential clinical benefit in carefully selected patients, though prospective studies are warranted.
Disciplines
Endocrine System Diseases | Medicine and Health Sciences | Nutritional and Metabolic Diseases
SODIUM-GLUCOSE COTRANSPORTER-2 INHIBITOR USE IN PATIENTS WITH CIRRHOSIS AND TYPE 2 DIABETES: IMPACT ON HEPATIC DECOMPENSATION AND HOSPITALIZATION
Background: SGLT2 inhibitors improve cardiovascular and renal outcomes in type 2 diabetes mellitus (T2DM), but their safety in cirrhosis remains uncertain given risks of volume depletion, infection, and decompensation. We evaluated the association between SGLT2 inhibitor use and hepatic decompensation and healthcare utilization in cirrhotic patients with T2DM.
Methods: A retrospective cohort study was performed using the TriNetX multicenter electronic health record network. Adults with cirrhosis and T2DM between 2018–2024 were classified as SGLT2 inhibitor-treated versus untreated. Propensity score matching (1:1) yielded 23,234 patients per group. Primary outcomes included new ascites, hepatic encephalopathy (HE), ED visits/inpatient admissions, and all-cause mortality. Secondary outcomes included clinical bleeding, infection, renal failure, and incident CKD. Risk ratios (RR) with 95% confidence intervals were estimated.
Results: SGLT2-treated patients had significantly lower risks of new ascites (6.9% vs. 12.4%; RR 0.56) and HE (3.7% vs. 5.3%; RR 0.69). ED/inpatient admissions were reduced (43.7% vs. 51.1%; RR 0.85), as was all-cause mortality (8.4% vs. 20.0%; RR 0.42). Secondary outcomes consistently favored SGLT2 therapy, including lower rates of clinical bleeding (8.2% vs. 11.2%; RR 0.73), infection (18.8% vs. 27.6%; RR 0.68), renal failure (10.2% vs. 14.6%; RR 0.70), and incident CKD (8.8% vs. 10.1%; RR 0.87).
Conclusions: In cirrhotic patients with T2DM, SGLT2 inhibitor use was associated with substantially lower risks of hepatic decompensation, hospitalization, mortality, and renal complications. These findings suggest potential clinical benefit in carefully selected patients, though prospective studies are warranted.