{
  "abstract": "Background and Aim: Fabry disease (FD) is frequently complicated by renal impairment and cardiovascular events; however, evidence on sodium–glucose cotransporter‐2 inhibitors (SGLT2i) in this population is scarce. Accordingly, we assessed the association between SGLT2i exposure and cardiovascular outcomes in adults with FD.\n\nMethods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, including adults with Fabry disease and eGFR ≥ 20 mL/min/1.73 m2, excluding Type 1 diabetes. Patients were stratified by SGLT2 inhibitor exposure. The primary outcome was a composite of all‐cause death, acute myocardial infarction and acute or acute‐on‐chronic heart failure at 2 and 5 years; secondary outcomes included individual components and progression to advanced kidney disease. Patients with prior non‐fatal outcomes were excluded from the respective analyses. Propensity score matching (1:1) and Cox proportional hazards models were used. Sensitivity analyses included alternative follow‐up periods, restriction to Fabry disease diagnosed from 2013 onwards and a stricter Fabry disease definition requiring ≥ 2 diagnoses; subgroup analyses were performed by sex and age.\n\nResults: Among 14 940 FD patients, 1028 (6.9%) had recorded exposure to SGLT2 inhibitors (mean age: 65.5 ± 12.0 years; 53.0% male), who were older and had a higher comorbidity burden and worse baseline renal profile than non‐exposed patients. After PSM, 732 patients per group (exposed and non‐exposed patients) were available for analysis. At 2 years, SGLT2i exposure was associated with a lower risk of the composite outcome (HR 0.61; 95% CI 0.38–0.97) and all‐cause death (HR 0.56; 95% CI 0.33–0.95). At 5 years, results were consistent for the composite outcome (HR 0.56; 95% CI 0.39–0.79) and all‐cause death (HR 0.62; 95% CI 0.42–0.93), with reduced myocardial infarction risk (HR 0.53; 95% CI 0.30–0.90).\n\nConclusions: In a large real‐world FD cohort, SGLT2i exposure was associated with lower cardiovascular risk and mortality, supporting further prospective investigation.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK",
    "Department of Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy",
    "Internal Medicine and Nephrology Division, ASL1 Avezzano‐Sulmona‐L'Aquila, San Salvatore Hospital L'Aquila Italy",
    "Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena Modena Italy",
    "Clinical and Experimental Medicine PhD Program University of Modena and Reggio Emilia Modena Italy",
    "Internal, Vascular and Emergency Medicine—Stroke Unit University of Perugia Perugia Italy",
    "Infiltrative Cardiomyopathy Program, Division of Cardiology University of Louisville Louisville Kentucky USA",
    "Danish Center for Health Services, Department of Clinical Medicine Aalborg University Aalborg Denmark",
    "Department of Cardiology, Lipidology and Internal Medicine With Intensive Coronary Care Unit Medical University of Bialystok Bialystok Poland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Leandra Serio",
      "orcid": "0009-0008-2568-3721"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Michele Rossi"
    },
    {
      "affs": [
        0
      ],
      "name": "Amir Askarinejad"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Enrico Tartaglia"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Tommaso Bucci",
      "orcid": "0000-0003-2895-6234"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Enrica Marrone"
    },
    {
      "affs": [
        6
      ],
      "name": "Dinesh K. Kalra"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Claudio Ferri"
    },
    {
      "affs": [
        0,
        7,
        8
      ],
      "name": "Gregory Y. H. Lip",
      "orcid": "0000-0002-7566-1626"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6sz773a3bz5ej.bib",
  "cited_by": 0,
  "doi": "10.1111/dom.71324",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731061/",
  "id": "6sz773a3bz5ej",
  "issns": [
    "1462-8902",
    "1463-1326"
  ],
  "landing_url": "https://doi.org/10.1111/dom.71324",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2716|Lysosomal Storage Disorders Research"
    ]
  ],
  "openalex": "W7212080926",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dom.71324",
  "pmcid": "PMC13731061",
  "pmid": "42712107",
  "published": "2026-09-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6sz773a3bz5ej.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:19Z",
      "native_id": "PMC13731061",
      "source": "pmc",
      "url": "https://doi.org/10.1111/dom.71324"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Lysosomal Storage Disorders Research",
      "subfield": "human-genetics"
    }
  ],
  "title": "SGLT2 Inhibitors and Cardiovascular Outcomes in Patients With Fabry Disease: Observations From a Federated Research Network",
  "title_text": "SGLT2 Inhibitors and Cardiovascular Outcomes in Patients With Fabry Disease: Observations From a Federated Research Network",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:19Z",
  "url": "https://research.draconitic.com/paper/6sz773a3bz5ej",
  "venue": "Diabetes, Obesity & Metabolism",
  "versions": []
}