Therapeutic Potential of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors in Liver Disease: Focus on Cirrhosis

Abstract

Cirrhosis, a progressive condition characterized by hepatic fibrosis and functional decline, remains a significant global health burden. Despite advancements in understanding its pathophysiology, effective therapies to halt or reverse progression are limited, especially in advanced stages. Cirrhosis decompensation represents an inflection point in the disease course, with a substantial increase in mortality. Ascites is the most common decompensating event, associated with significant morbidity and healthcare burden, making it a key target in the management of decompensated cirrhosis. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, widely used for type 2 diabetes mellitus, have demonstrated potential beyond glucose regulation. Evidence from clinical and preclinical studies suggests that SGLT2 inhibitors may improve hepatic parameters, reduce hepatic steatosis and fibrosis, and mitigate complications such as ascites. This review explores the multifaceted effects of SGLT2 inhibitors on cirrhosis, focusing on their mechanisms, clinical implications, and therapeutic potential in cirrhosis. By addressing current gaps in therapeutic strategies, SGLT2 inhibitors may represent a novel avenue for improving outcomes in patients with cirrhosis.

Keywords: anti-inflammatory effect; compensated liver cirrhosis disease; complications of cirrhosis; decompensated liver cirrhosis; diuretic-resistant ascites; hepatocellular carcinoma (hcc); hepatorenal syndrome (hrs); liver cirrhosis; sglt2-inhibitors; sodium-glucose cotransporter-2 (sglt2) inhibitors.