Gliflozins

Gliflozins are drugs originally developed for the treatment of type 2 diabetes mellitus for their effect inhibiting the sodium-glucose cotransporter type 2 in the kidneys and thereby promoting urinary glucose loss. Yet, gliflozins can also benefit patients with heart failure through a mechanism likely associated with inhibition of the sodium-hydrogen exchanger isoform 1 (NHE-1). We have shown in animal models that NHE-1 inhibitors given during cardiac resuscitation reduce injury to the heart muscle resulting in more effective CPR, better cardiac function after resuscitation, and higher survival. We recently showed that gliflozins can elicit similar cardiac effects as NHE-1 inhibitors. Clinical translation of these effects would be facilitated by the 505(b)(2) pathway designed to repurpose clinically available drugs.