End of 2022 Wrap Up: SGLT2 Inhibitors, COVID-19 Treatments and Boosters

Volume 22, Issue 5

Another year is in the books, and this year is something special: this was the first full calendar year that Talking Therapeutics was published! So, I’m taking this opportunity to make a big shout out and to offer many thanks to our regular readers here at Talking Therapeutics. Your continued support allows us to continue to bring you the latest therapeutic updates in a pithy 400-word weekly column.

In the spirt of this year’s wrap-up column, I’d like to take stroll down memory lane and revisit some of the most impactful stories from 2022.

The Rise and Rise and Rise of SGLT2 Inhibitors

I think by far one of the most important studies this year was the meteoric rise of SGLT2 inhibitors for patients with heart failure. Their salutary benefits were already well known for patients with reduced ejection fraction heart failure. However, the big breakthrough was the data demonstrating these agents can provide similar benefits for patients with preserved ejection heart failure. Prior to SGLT2 inhibitors, no other drug class demonstrated the ability to reduce heart failure-related morbidity and mortality for these patients.

Additionally, data emerged showing the SGLT2 inhibitors can also effectively decongest patients admitted to hospital for acute heart failure exacerbation and using these agents in the hospital can reduce the risk of readmission after discharge.

The Rise and Fall and Rise and Fall of Monoclonal Antibodies for COVID-19

This year, a new pattern emerged for the monoclonal antibody products used to treat COVID-19 infection. This was truly the year of Omicron, starting with the wild type strain in January, then the BA.2 strain in the spring, and then newer strains like BA.5 and BQ.1 in the fall. As these strains have emerged, our drug therapy has had to shift.

Sotrovimab was initially effective against the wild-type variant but lost efficacy once BA.2 took over. Bebtelovimab then emerged as the monoclonal antibody of choice to treat BA.2, and luckily remained effective for BA.4 and BA.5. Unfortunately, the new BQ.1 and BQ1.1 variants have neutralized bebtelovimab, and presently, we do not have an effective monoclonal antibody treatment for patients infected with new strains of COVID-19.

The Durability of Bivalent Boosters and Paxlovid

Despite the demise of our monoclonal antibody products, we can end the column on a positive note. The newly deployed bivalent boosters against COVID-19 appear to provide robust immunity against infection from all strains of Omicron, including the new BQ strains. The other piece of good news is the durability of Paxlovid, which so far continues to show good activity against all the currently circulating Omicron variants.