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Peer-reviewedCC BYDiabetology & metabolic syndrome

Empagliflozin's role in cardiometabolic disease treatment: an Egyptian expert's view.

  • Samir H Assaad-Khalil1,2
  • Fawzy Elmessallamy3
  • Khaled Elsayed Elhadidy4
  • Mohamed Hesham El Hefnawy5
  • Mohamed Reda Halawa6
  • Mohamed Zeitoun7
  • Shady Hussein8
  • Ibrahim Elebrashy9
9 affiliations
  1. 1Unit of Diabetes, Lipidology & Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt. [email protected].
  2. 2Department of Internal Medicine, Unit of Diabetes, Lipidology, and Metabolism, Faculty of Medicine, Alexandria University, Alexandria Governorate, Alexandria, Egypt. [email protected].
  3. 3Diabetes and Endocrine Unit, Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
  4. 4Diabetes and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
  5. 5National Institute of Diabetes and Endocrinology, Cairo, Egypt.
  6. 6Department of Endocrinology, Ain Shams University, Cairo, Egypt.
  7. 7Unit of Diabetes, Lipidology & Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
  8. 8Department of Cardiology, Mansoura University, Mansoura, Egypt.
  9. 9Department of Internal Medicine and Diabetes, Cairo University, Cairo, Egypt.
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Abstract

Background

Given the expanding therapeutic indications of empagliflozin (EMPA) beyond glycemic control and the growing burden of cardiometabolic diseases, this review evaluated its efficacy, safety, and cost-effectiveness in the Egyptian population within the global context.Methods

A comprehensive literature review of PubMed and Google Scholar identified clinical trials, systematic reviews, meta-analyses, and clinical guidelines published in English up to July 2025. We included studies reporting EMPA's pharmacological profile, mechanisms of action, and clinical outcomes on diabetes mellitus, cardiometabolic diseases, renal and hepatic functions, safety during Ramadan fasting, and cost-effectiveness.Results

EMPA, as monotherapy or combination therapy, improves glycemic control in type 2 diabetes through Sodium-glucose co-transporter-2 (SGLT-2) inhibition. For type 1 diabetes mellitus, despite improving glycemic control as an adjunct therapy, it is not recommended due to the increased risk of diabetic ketoacidosis. EMPA reduces major cardiovascular events, heart failure hospitalization, and chronic kidney disease progression, with modest weight loss and blood pressure reduction, in patients with or without diabetes. Emerging evidence suggests benefits in metabolic dysfunction-associated steatotic liver disease (MASLD), although it is not approved for this indication. EMPA demonstrates a favorable safety profile and low hypoglycemia risk during Ramadan fasting. It enhances patients' quality of life and is considered cost-effective.Conclusions

EMPA extends beyond glucose-lowering by reducing cardiorenal morbidity and mortality in patients with or without diabetes. It shows a favorable safety profile, even during Ramadan fasting, supporting its suitability for the large Muslim population. Further research should evaluate its role in MASLD and assess cost-effectiveness in Egypt.

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Cite

BibTeXRIS
BibTeX
@article{assaadkhalil2026empagliflozins,
  title = {{Empagliflozin's role in cardiometabolic disease treatment: an Egyptian expert's view.}},
  author = {Samir H Assaad-Khalil and Fawzy Elmessallamy and Khaled Elsayed Elhadidy and Mohamed Hesham El Hefnawy and Mohamed Reda Halawa and Mohamed Zeitoun and Shady Hussein and Ibrahim Elebrashy},
  journal = {Diabetology \& metabolic syndrome},
  year = {2026},
  month = oct,
  doi = {10.1186/s13098-026-02312-y},
  url = {https://europepmc.org/article/MED/42963793},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Empagliflozin's role in cardiometabolic disease treatment: an Egyptian expert's view.
AU  - Samir H Assaad-Khalil
AU  - Fawzy Elmessallamy
AU  - Khaled Elsayed Elhadidy
AU  - Mohamed Hesham El Hefnawy
AU  - Mohamed Reda Halawa
AU  - Mohamed Zeitoun
AU  - Shady Hussein
AU  - Ibrahim Elebrashy
PY  - 2026
DA  - 2026/10/30
JO  - Diabetology & metabolic syndrome
DO  - 10.1186/s13098-026-02312-y
UR  - https://europepmc.org/article/MED/42963793
AB  - Background  Given the expanding therapeutic indications of empagliflozin (EMPA) beyond glycemic control and the growing burden of cardiometabolic diseases, this review evaluated its efficacy, safety, and cost-effectiveness in the Egyptian population within the global context.Methods  A comprehensive literature review of PubMed and Google Scholar identified clinical trials, systematic reviews, meta-analyses, and clinical guidelines published in English up to July 2025. We included studies reporting EMPA's pharmacological profile, mechanisms of action, and clinical outcomes on diabetes mellitus, cardiometabolic diseases, renal and hepatic functions, safety during Ramadan fasting, and cost-effectiveness.Results  EMPA, as monotherapy or combination therapy, improves glycemic control in type 2 diabetes through Sodium-glucose co-transporter-2 (SGLT-2) inhibition. For type 1 diabetes mellitus, despite improving glycemic control as an adjunct therapy, it is not recommended due to the increased risk of diabetic ketoacidosis. EMPA reduces major cardiovascular events, heart failure hospitalization, and chronic kidney disease progression, with modest weight loss and blood pressure reduction, in patients with or without diabetes. Emerging evidence suggests benefits in metabolic dysfunction-associated steatotic liver disease (MASLD), although it is not approved for this indication. EMPA demonstrates a favorable safety profile and low hypoglycemia risk during Ramadan fasting. It enhances patients' quality of life and is considered cost-effective.Conclusions  EMPA extends beyond glucose-lowering by reducing cardiorenal morbidity and mortality in patients with or without diabetes. It shows a favorable safety profile, even during Ramadan fasting, supporting its suitability for the large Muslim population. Further research should evaluate its role in MASLD and assess cost-effectiveness in Egypt.
SN  - 1758-5996
ER  -