J. Pharm. Pharmacogn. Res., vol. 14, no. 1, Article ID 2253, Jan-Feb 2026.
DOI: https://doi.org/10.56499/jppres_14.1.2253Review
Current landscape and future potential of sodium-glucose cotransporter 2 inhibitors in heart failure: A systematic review and bibliometric analysis
[Panorama actual y potencial futuro de los inhibidores del cotransportador de sodio y glucosa tipo 2 en la insuficiencia cardíaca: una revisión sistemática y análisis bibliométrico]
Christopher D. Tristan1,4, Risalina Myrtha2,3*, Nanang Wiyono4, Irnizarifka Irnizarifka2,3
1Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
2Department of Cardiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
3Universitas Sebelas Maret Hospital, Sukoharjo, Central Java, Indonesia.
4Department of Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
*E-mail: risalinamustarsid@staff.uns.ac.id
Abstract
Context: Despite extensive trials of sodium-glucose cotransporter 2 (SGLT2) inhibitors in heart failure (HF), comprehensive analyses identifying emerging themes and knowledge gaps remain limited.
Aims: To explore evolving areas and identify knowledge gaps on SGLT2 inhibitors in HF.
Methods: A hybrid methodology was adopted. Bibliometric analysis using Scopus (as of May 12, 2025) was conducted with Biblioshiny and VOSviewer to assess research output, key contributors, and thematic trends. A subsequent systematic review, conducted using PubMed, Scopus, and ScienceDirect, was conducted for each identified trend, and the quality was assessed using the ROBINS-I and RoB 2.0 tools. Meta-analysis was performed using RStudio.
Results: A total of 621 studies were included in the bibliometric analysis. Emerging themes included “ertugliflozin,” “acute heart failure,” and “fibrosis.” Six studies on ertugliflozin indicate promising results, although clinical outcomes such as HF rehospitalization and cardiovascular mortality remain unexamined. Fifteen studies assessing SGLT2 inhibitors in acute heart failure (AHF) suggested that early initiation may be clinically beneficial, with notable improvements in diuretic efficacy, diuretic response, symptom relief, and a reduced risk of composite outcomes [HR: 0.64; 95% CI: 0.47–0.86; p = 0.003], without significant adverse events. Studies assessing the effects of SGLT2 inhibitors on myocardial fibrosis have demonstrated a greater reduction in extracellular volume at 6 months [MD: −1.48; 95% CI: −1.71 to −1.25; p<0.0001]. However, biomarker-based findings across four studies were inconsistent, underscoring the need for further investigation.
Conclusions: While ertugliflozin and SGLT2 inhibitors in AHF show promise, further clinical investigations are warranted, particularly regarding long-term outcomes and myocardial fibrosis.
Keywords: acute heart failure; bibliometric; fibrosis; heart failure; SGLT2 inhibitors.
Resumen
Contexto: A pesar de los extensos ensayos con inhibidores del cotransportador de sodio-glucosa tipo 2 (SGLT2) en la insuficiencia cardíaca (IC), los análisis exhaustivos que identifican temas emergentes y lagunas de conocimiento siguen siendo limitados.
Objetivos: Explorar áreas en desarrollo e identificar lagunas de conocimiento sobre los inhibidores de SGLT2 en la IC.
Métodos: Se adoptó una metodología híbrida. Se realizó un análisis bibliométrico mediante Scopus (al 12 de mayo de 2025) con Biblioshiny y VOSviewer para evaluar la producción científica, los autores clave y las tendencias temáticas. Posteriormente, se realizó una revisión sistemática, realizada con PubMed, Scopus y ScienceDirect, para cada tendencia identificada, y se evaluó su calidad mediante las herramientas ROBINS-I y RoB 2.0. El metanálisis se realizó con RStudio.
Resultados: Se incluyeron 621 estudios en el análisis bibliométrico. Los temas emergentes incluyeron «ertugliflozina», «insuficiencia cardíaca aguda» y «fibrosis». Seis estudios sobre ertugliflozina indican resultados prometedores, aunque aún no se han analizado desenlaces clínicos como la rehospitalización por IC y la mortalidad cardiovascular. Quince estudios que evaluaron los inhibidores de SGLT2 en la insuficiencia cardíaca aguda (ICA) sugirieron que el inicio temprano podría ser clínicamente beneficioso, con mejoras notables en la eficacia y la respuesta diurética, el alivio de los síntomas y una reducción del riesgo de resultados compuestos [HR: 0,64; IC del 95%: 0,47-0,86; p = 0,003], sin eventos adversos significativos. Los estudios que evaluaron los efectos de los inhibidores de SGLT2 en la fibrosis miocárdica han demostrado una mayor reducción del volumen extracelular a los 6 meses [DM: -1,48; IC del 95%: -1,71 a -1,25; p<0,0001]. Sin embargo, los hallazgos basados en biomarcadores en cuatro estudios fueron inconsistentes, lo que subraya la necesidad de mayor investigación.
Conclusiones: Si bien la ertugliflozina y los inhibidores de SGLT2 en la ICA muestran resultados prometedores, se justifican más investigaciones clínicas, en particular en relación con los resultados a largo plazo y la fibrosis miocárdica.
Palabras Clave: bibliometría; fibrosis; inhibidores de SGLT2; insuficiencia cardíaca; insuficiencia cardíaca aguda.
Citation Format: Tristan CD, Myrtha R, Wiyono N, Irnizarifka I (2026) Current landscape and future potential of sodium glucose co-transporter 2 inhibitors in heart failure: A systematic review and bibliometric analysis. J Pharm Pharmacogn Res 14(1): 2253. https://doi.org/10.56499/jppres_14.1.2253
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