Nov. 15 at 10:49 AM
$LXRX Engineer here. Sotagliflozin is a new class of HF med due to SGLT1 inhibition. Other gliflozins are SGLT2 inhibitors. In kidney, SGLT2i is 9 times more effective than SGLT1i, thus much more effective in regulating glucose. Don't forget Sota is SGLT2i also as a dual SGLT1 & 2 inhibitors. The reason why Sota missed the T2DM market is not because it is not effective, but it missed the market timing due to Sanofi mishap results in shortened runway before generic SGLT2i flooding the markets.
SGLT1 has been detected in guts, heart, brain and muscle, but there is almost no trace of SGLT2 in those tissues. That's why you can see why SGLT1i has been shown beneficial in preventing postprandial glucose spike, HF, MI, stroke and HCM. HFpEF is notoriously difficult to treat than HFrEF, and Sota has been shown effective in reducing both HFrEF & HFpEF risks.
Inpefa's NNT is 4 in preventing HHF & CBD death, while all others' are around 20 and GLP-1's is 60.
We like to know how things work.
