Dapagliflozin and Anemia Outcomes: A Systematic Review and Meta-Analysis of Effects on Hemoglobin Levels, Anemia Correction, and Incidence in Patients With and Without Heart Failure

This systematic review and meta-analysis evaluated the impact of dapagliflozin on anemia outcomes across different patient populations. A comprehensive literature search was conducted across multiple databases from inception to September 2025, identifying studies that reported anemia-related outcomes in adult patients receiving dapagliflozin treatment. Seven studies comprising 15,540 participants were included, encompassing randomized controlled trials and observational studies conducted across diverse geographical regions. All studies evaluated 10 mg of dapagliflozin once daily with a minimum four-week follow-up duration. The pooled analysis demonstrated significant improvements in hemoglobin levels with dapagliflozin compared to control groups (standardized mean difference [SMD]: 0.62; 95% CI: 0.43-0.80). Dapagliflozin treatment was associated with an 83% higher likelihood of anemia correction (relative risk: 1.83; 95% CI: 1.47-2.26) and a 78% reduction in anemia incidence (relative risk: 0.22; 95% CI: 0.08-0.60). Subgroup analyses revealed consistent benefits across all studied populations, with the most pronounced effects observed in heart failure patients (SMD: 0.78; 95% CI: 0.44-1.12), followed by chronic kidney disease (0.66; 95% CI: 0.36-0.95) and diabetes patients (0.45; 95% CI: 0.38-0.51). These findings suggest that dapagliflozin's therapeutic benefits extend beyond cardiovascular and renal protection to include meaningful improvements in anemia outcomes across multiple chronic disease states, potentially reducing healthcare burden and improving patient quality of life.