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Review
. 2023 Jun;22(2):343-347.
doi: 10.1007/s42000-023-00430-0. Epub 2023 Jan 19.

Long-term efficacy of empagliflozin as an add-on treatment for chronic SIAD: a case report and literature review

Fabio Bioletto  1 , Emanuele Varaldo  1 , Nunzia Prencipe  1 , Andrea Benso  1 , Alessandro Maria Berton  2
Affiliations
Review

Long-term efficacy of empagliflozin as an add-on treatment for chronic SIAD: a case report and literature review

Fabio Bioletto et al. Hormones (Athens). 2023 Jun.

Abstract

Background: SLGT-2 inhibitors have recently been investigated as a promising therapy for syndrome of inappropriate antidiuresis (SIAD). However, to our knowledge, no report has been published about their use for this indication in the long term.

Case presentation: We report the case of a 68-year-old male with type 2 diabetes and chronic SIAD, in whom serum sodium levels were not adequately controlled by urea monotherapy. Other treatment options were not viable due to inefficacy or adverse effects. The initiation of empagliflozin, in addition to urea, led to the full normalization of serum sodium. Reduction and subsequent discontinuation of urea were attempted upon patient request, but this resulted in a relapse of hyponatremia. Nevertheless, stable normonatremia was again achieved and maintained for more than 6 months after re-establishing a combination therapy with empagliflozin and urea.

Conclusions: SGLT2 inhibitors might represent an effective treatment for SIAD, even in the long term. Specific clinical trials are needed to confirm this result.

Keywords: Empagliflozin; Hyponatremia; SGLT2 inhibitors; Syndrome of inappropriate antidiuresis; Urea.

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