Exploring evidence of SGLT2 inhibitors use in Southeast Asia: a systematic review

BackgroundThe benefits of sodium glucose cotransporter 2 (SGLT2) inhibitors are increasingly recognized, not only in the management of diabetes but also in cardiovascular and renal conditions. However, evidence regarding SGLT2 inhibitor use in Southeast Asian populations remains limited and has yet to be systematically reviewed. MethodsA systematic literature search was conducted in Ovid Medline, Cochrane Central Register of Controlled Trials and Embase from database inception until 21 October 2024. Studies were included if they were conducted in adults living in Southeast Asian countries and contained information on the use of SGLT2 inhibitors. ResultsA total of 23 studies were included. These studies were conducted in only 5 out of 11 countries in the region (Malaysia, Philippines, Singapore, Thailand and Vietnam). Among these 23 studies, 12 were conducted in patients with type 2 diabetes, 7 in patients with heart failure, and 4 in patients with chronic kidney disease. Thirteen studies focused on economic evaluations. Limited evidence from these 5 countries suggests that SGLT2 inhibitors appear to be safe, effective, and are likely to be cost-effective and cost-saving. ConclusionsPublished evidence in Southeast Asian countries showed that SGLT2 inhibitor treatment may offer promising benefits for patients with type 2 diabetes, heart failure and chronic kidney disease. Further research is needed to understand the availability and affordability, as well as the safety, of SGLT2 inhibitors, taking into consideration the effect of ageing and frailty in this region. In addition, key region-specific factors, such as genetic variations, healthcare infrastructure, and cultural considerations remain to be addressed.