Sotagliflozin and Hospitalizations in People With Heart Failure

There are many drugs used to treat heart failure, and even more are being researched. Recently, a drug called sotagliflozin has shown potential for treating heart failure after hospitalization.

What is sotagliflozin?

Sotagliflozin was first developed for treating diabetes. It is made by the company Lexicon Pharmaceuticals and goes by the brand name Zynquista. It is a type of drug called a sodium-glucose cotransporter type 2 inhibitor (SGLT2 inhibitor). SGLT2 inhibitors work by limiting the amount of sugar the kidneys and intestines absorb. This helps lower and regulate the amount of sugar in the blood.¹

Lexicon developed sotagliflozin to treat type 1 and 2 diabetes. The company wanted it approved for type 1 diabetes since there are already many existing treatments for type 2 diabetes. However, the U.S. Food and Drug Administration (FDA) did not approve sotagliflozin for type 1 diabetes. The FDA has only approved SGLT2 inhibitors for treating type 2 diabetes. Sotagliflozin is approved to treat both type 1 and 2 diabetes in Europe.^1-3

In addition to diabetes, SGLT2 inhibitors are studied for their impact on heart failure. They have lowered the risk of death and hospitalization in people with stable heart failure. This benefit has been seen in people both with and without diabetes.⁴

Previously, it was not clear if SGLT2 inhibitors were safe for all people with heart failure. There was no research on SGLT2 inhibitors for people who had recently experienced a serious heart failure event leading to a hospital visit.

Evidence for people with heart failure

New research on sotagliflozin was released in November 2020. One study focused on people with type 2 diabetes who had been hospitalized for worsening heart failure. Of 1,222 people in the study, half took sotagliflozin when they left the hospital, and the other half took placebos (inactive treatments).^4-6

Researchers found that the people who took sotagliflozin had about a 33 percent lower chance of follow-up hospitalization or death. For people taking sotagliflozin, they found possible side effects were low blood sugar and diarrhea.⁴

The same researchers did a similar study on people with type 2 diabetes, chronic kidney disease, and risk for heart disease. In this study, the people on sotagliflozin also experienced benefits. They had a 25 percent lower chance of hospitalization or death related to heart failure.⁶

These results could improve treatment for people with diabetes in the hospital for heart failure. Lowering the chance of hospital visits is an important step in the long-term management of heart failure.⁷

Future as a heart failure treatment

Unfortunately, these studies lost funding because of COVID-19 and had to end early. Researchers had planned to enroll more people and monitor them for longer.

The future of sotagliflozin as any treatment in the United States is unclear. Sotagliflozin lost its biggest investor when it did not get FDA approval for treating type 1 diabetes. However, the new heart failure studies were funded by Lexicon Pharmaceutics. Sotagliflozin will still need FDA approval for any use.⁸

More research is needed before doctors determine if sotagliflozin is safe and effective after heart failure-related hospitalization. If you are hospitalized because of heart failure, ask your doctor about options for safely lowering your chances of returning.