Key result
Empagliflozin cuts renal impairment ~35% and reduces cardiovascular events with favorable safety.
Why the study?
The expanding therapeutic indications of empagliflozin beyond glycemic control and the growing burden of cardiometabolic diseases motivated an evaluation of its efficacy, safety, and cost-effectiveness in the Egyptian population within the global context.
Does empagliflozin improve cardiometabolic, renal, and hepatic outcomes while maintaining safety and cost-effectiveness in patients with cardiometabolic diseases, particularly in the Egyptian population?
Does empagliflozin improve cardiometabolic, renal, and hepatic outcomes while maintaining safety and cost-effectiveness in patients with cardiometabolic diseases, particularly in the Egyptian population?
This narrative review highlights that empagliflozin provides broad cardiorenal and metabolic benefits beyond glycemic control—including safe use during Ramadan fasting—supporting its clinical utility in Egyptian and global patient populations.
Supports consideration in Egyptian CKD patients during Ramadan; leaves open dedicated RCTs for confirmation.
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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Khalil et al. (2026) conducted a review in Cardiometabolic diseases, diabetes mellitus, heart failure, chronic kidney disease, and metabolic dysfunction-associated steatotic liver disease. Empagliflozin vs. Placebo, standard of care, or active comparators (e.g., sitagliptin, glimepiride, pioglitazone) was evaluated.
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