{"id":"3db1e067b68f","type":"article","url":"https://hartvaat.nl/2026/08/21/frailheid-en-laag-bmi-bepalen-sglt2-remmerstopt-bij-ouderen-75-jaar/","title":"Frailheid en laag BMI bepalen SGLT2-remmerstopt bij ouderen ≥75 jaar","title_en":"Frailty and low body mass index as key determinants of sodium-glucose cotransporter 2 inhibitor-specific adverse event-related discontinuation in adults aged ≥75 years: A multicenter real-world retrospective cohort study.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Journal of diabetes investigation","doi":"10.1111/jdi.70424","source_url":"https://doi.org/10.1111/jdi.70424","authors":["Taisuke Uchida","Hiroaki Ueno","Ayaka Konagata","Hiroki Nabekura","Yuki Kikuchi","Takumi Beppu","Akari Sekishima","Hirotaka Sekishima","Takayuki Nakamura","Fumiko Kogo","Yudai Uehira","Yuri Tanaka","Hideki Yamaguchi","Kazuya Shimoda"],"significance":5,"published":"2026-08-30","source_date":"2026-08-21","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/antiaritmica-farmacologie/","https://hartvaat.nl/kennis/hartfalen/arni-sacubitril-valsartan/"],"congress":"","summary_en":"A multicenter retrospective cohort study evaluated 616 Japanese adults aged ≥75 years newly initiating an SGLT2 inhibitor. Over 180 days, 9.1% discontinued treatment due to drug-specific adverse events. Multivariable analysis identified clinical frailty (score ≥5; HR 4.67) and low BMI (<22 kg/m²; HR 2.53) as independent predictors of discontinuation, whereas chronological age alone was not. These findings suggest that physiological reserve and nutritional status, rather than age per se, should guide monitoring and support the safe use of SGLT2 inhibitors in older adults.","created":"2026-08-23T01:24:56Z","updated":"2026-08-23T01:24:56Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een multicenter retrospectieve cohortstudie onder 616 Japanse ouderen ≥75 jaar die nieuw met een SGLT2-remmer begonnen, toonde aan dat na 180 dagen 9,1% stopte vanwege medicijnspecifieke bijwerkingen. Multivariaat analyse wees uit dat een Clinical Frailty Scale-score ≥5 (HR 4,67) en een BMI <22 kg/m² (HR 2,53) onafhankelijke voorspellers van stoppen waren, terwijl chronologische leeftijd op zich geen risicofactor was. Deze bevindingen benadrukken dat fysiologische reserve en voedingstoestand belangrijker zijn dan leeftijd alleen bij het voorschrijven van SGLT2-remmers, wat klinische monitoring kan sturen voor veilig gebruik in deze kwetsbare groep.","abstract_original":"AIMS/INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are increasingly prescribed to older adults; however, data regarding their tolerability and drug-specific adverse events (AEs) in very elderly Asian populations, particularly among individuals with frailty or low body mass index (BMI), remain limited. We aimed to determine the incidence of SGLT2i-specific AE-related treatment discontinuation and to identify associated risk factors among Japanese adults aged ≥75 years. MATERIALS AND METHODS: We conducted a multicenter retrospective cohort study including Japanese adults aged ≥75 years who newly initiated SGLT2is between 2014 and 2024. Medical records were reviewed for 180 days. SGLT2i-specific AEs were defined as genitourinary infection, volume depletion, acute kidney function decline, and diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome. Cox proportional hazards models were used for identifying predictors. RESULTS: A total of 616 patients were included (mean age, 81.3 years; mean BMI, 24.0 kg/m2). The 180-day cumulative incidence of SGLT2i-specific AE-related discontinuation was 9.1%. Multivariable analysis identified Clinical Frailty Scale ≥5 (hazard ratio [HR], 4.67; P < 0.001) and BMI <22 kg/m2 (HR, 2.53; P = 0.003) as independent predictors of discontinuation. CONCLUSIONS: SGLT2 inhibitors were generally well tolerated among adults aged ≥75 years. Frailty and low BMI were the principal determinants of AE-related treatment discontinuation, whereas chronological age was not independently associated with the risk. Assessment of physiological reserve may help identify patients requiring closer monitoring and support the safe use of SGLT2 inhibitors in older adults."}