Popular diabetes drug shown to lower inflammation, which may protect the heart

by Jill Clendening, Vanderbilt University Medical Center

edited by Sadie Harley, reviewed by Andrew Zinin

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For the first time in a human trial, a class of drugs known as sodium-glucose cotransporter-2 (SGLT2) inhibitors, already known for their weight-loss and glucose-lowering benefits, has also been shown to reduce inflammatory cells in the blood known to cause cardiovascular disease. The findings were published in Circulation.

"There had been some suggestive studies in animals with these medications indicating they might be modulating the immune system—affecting inflammation—but that hadn't really been shown in humans," said Mona Mashayekhi, M.D., Ph.D., assistant professor of medicine in the Division of Diabetes, Endocrinology and Metabolism at Vanderbilt Health.

"This study provides the first direct evidence of SGLT2 inhibitors altering human immune cells, which may reduce cardiovascular risk.

"This finding is significant because it's the first time this medication has been shown to have an immune effect at the cellular level with some specificity. If we understand how these medicines are reducing obesity-associated inflammation, heart disease and kidney disease, then we can identify the best patient for this treatment or discover other drug targets in that pathway that could really be beneficial."

The research team enrolled 16 women with obesity and prediabetes and treated them with the SGLT2 inhibitor empagliflozin. They performed baseline testing, then gave study participants the medication for a total of three months. They also reviewed immune changes in a comparator cohort of women who went on a low-calorie diet for three months. They took measurements at two weeks and then at three months.

Using advanced genetic sequencing and cellular imaging, investigators discovered that levels of monocyte-platelet aggregates, or MPAs—a cell type thought to contribute to vascular inflammation and cardiovascular disease—were significantly reduced in the blood. MPAs are cell aggregates formed when blood-clotting cells (platelets) stick to immune cells (monocytes).

Individuals taking the drug saw a significant drop in these inflammatory cell clumps within just two weeks, and the reduction grew even stronger by week 12. Only the group receiving the medication had reduced MPAs, indicating the medication's heart-protective benefits go beyond simple weight loss.

Beyond the reduction in MPAs, the investigators also documented "metabolic reprogramming" of the patients' monocytes (immune cells). They shifted from a hyperinflammatory state toward a healthier, more stable state focused on normal cellular energy.

Mashayekhi and her colleagues have already begun a randomized, placebo-controlled trial, currently enrolling at Vanderbilt Health, with a planned cohort of 74 participants with obesity and metabolic syndrome. Changes in immune measures over three months will be analyzed as in the pilot study, but this time, adipose tissue (fat) will also be collected and analyzed to better understand obesity-associated inflammation.

Publication details

B. Ilkin Safa et al, SGLT2 Inhibitor Empagliflozin Reduces Circulating Monocyte-Platelet Aggregates: A Pilot Study, Circulation (2026). DOI: 10.1161/circulationaha.125.077432

Journal information: Circulation

Key medical concepts

empagliflozinMonocytesvascular inflammationsCardiovascular Diseases

Clinical categories

EndocrinologyCardiologyWeight management Provided by Vanderbilt University Medical Center Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

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Citation: Popular diabetes drug shown to lower inflammation, which may protect the heart (2026, October 6) retrieved 6 October 2026 from https://medicalxpress.com/news/2026-10-popular-diabetes-drug-shown-inflammation.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.