Stephen Greene, MD, Gives Insight on the New Heart Failure Drug Sotagliflozin

Stephen Greene, MD, Co-Director, Duke Heart Failure Medication Titration Clinic Division of Cardiology at Duke University School of Medicine, explains that Inpefa (sotagliflozin), a recently FDA-approved dual SGLT-1 and SGLT-2 inhibitor, aims to reduce cardiovascular death, heart failure, hospitalizations, or urgent heart failure visits among patients with heart failure, chronic kidney disease, type 2 diabetes, and another cardiovascular risk factor.

Two pivotal trials, SOLOIST-WHF and SCORED, support the FDA indications.

Inpefa distinguishes itself by being a combination inhibitor, addressing both SGLT-1 and SGLT-2.

Although no head-to-head trials compare it with other SGLT inhibitors, Greene claims the class has shown overwhelming clinical benefits, supporting its use across different ejection fractions in heart failure treatment.

The Score trial demonstrated approximately a 20-25% reduction in the primary endpoint of cardiovascular death, heart failure hospitalizations, and urgent heart failure visits.

Greene emphasized the need for prompt therapy initiation to avoid needless exposure to excess clinical risk, reinforcing the medication's effectiveness.