# SGLT2-remmers verlagen sterfte en leverdecompensatie bij cirrose — real-world cohortstudie

*geplaatst 2026-09-05 · Hartfalen · European journal of gastroenterology & hepatology · doi 10.1097/MEG.0000000000003264 · https://hartvaat.nl/2026/10/01/sglt2-remmers-verlagen-sterfte-en-leverdecompensatie-bij-cirrose-real-world-coho/*

In een retrospectieve cohortstudie met 69.180 patiënten met cirrose werd het gebruik van SGLT2-remmers geassocieerd met een lager risico op overlijden (HR 0,67) en leverdecompensatie (HR 0,78) vergeleken met niet-gebruikers. Het risico op acute nierinsufficiëntie of hepatorenal syndroom nam niet toe, terwijl ook het aantal nieuwe gevallen van hepatocellulair carcinoom significant lager was. Deze real-world bevindingen suggereren dat SGLT2-remmers veilig en potentieel nuttig kunnen zijn bij cirrose, maar bevestigen dat prospectieve trials nodig zijn om de rol in deze populatie definitief te bepalen.

## English: Sodium-glucose cotransporter-2 inhibitor use and clinical outcomes in patients with cirrhosis: a propensity-matched real-world cohort study.

In a propensity-matched retrospective cohort of 69,180 patients with cirrhosis, SGLT2 inhibitor use was associated with significantly lower all-cause mortality (HR 0.67) and hepatic decompensation (HR 0.78) compared to non-use. Importantly, SGLT2 inhibitors did not increase the risk of acute kidney injury or hepatorenal syndrome, and were linked to a reduced incidence of hepatocellular carcinoma. While these real-world findings support the potential cardiorenal and hepatic benefits of SGLT2 inhibitors in cirrhosis, prospective trials are needed to establish definitive clinical guidelines.

## Abstract (original, from the publication)

BACKGROUND: Patients with cirrhosis frequently have metabolic comorbidities that complicate treatment. Sodium-glucose cotransporter-2 (SGLT2) inhibitors provide cardiovascular and renal benefits in type 2 diabetes, but their effects in cirrhosis remain uncertain. We evaluated the association between SGLT2 inhibitor use and clinical outcomes in patients with cirrhosis. METHODS: We conducted a retrospective cohort study using the TriNetX Research Network. Adults with cirrhosis were stratified by SGLT2 inhibitor exposure. Propensity score matching balanced demographics, comorbidities, medication use, BMI, and laboratory variables. Outcomes included all-cause mortality, hepatic decompensation, acute kidney injury/hepatorenal syndrome (AKI/HRS), and hepatocellular carcinoma (HCC). RESULTS: After matching, 34 590 patients remained in each cohort. SGLT2 inhibitor use was associated with lower all-cause mortality [15.0 vs. 24.2%; hazard ratio: 0.67, 95% confidence interval (CI): 0.64-0.69, P < 0.001] and composite hepatic decompensation (28.6 vs. 36.3%; hazard ratio: 0.78, 95% CI: 0.76-0.80, P < 0.001). AKI/HRS was not increased on time-to-event analysis (hazard ratio: 0.99, 95% CI: 0.96-1.02, P = 0.346). HCC incidence was lower among SGLT2 inhibitor users (hazard ratio: 0.57, 95% CI: 0.39-0.86, P = 0.006). CONCLUSION: SGLT2 inhibitor use in patients with cirrhosis was associated with lower mortality, hepatic decompensation, and HCC incidence without increased AKI/HRS. These findings support prospective evaluation in selected patients with cirrhosis.

Auteurs: Elias Helal, Elona Shehi, Ahmad Al Homaid, Migena Dervishi, Devendra K Tripathi

---
Bron: European journal of gastroenterology & hepatology, https://doi.org/10.1097/MEG.0000000000003264. Bijgewerkt 2026-08-29T01:03:03Z. 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.