Sotagliflozin is a dual sodium-glucose co-transporter (SGLT) 2 inhibitor, 
manifesting a 20-fold higher inhibitory activity for SGLT2 than for SGLT1. 
Differences in SGLT2 over SGLT1 selectivity of the available agents have been 
proposed to relate to variability in efficacy and safety characteristics. In 
contrast to other SGLT2 inhibitors, the cardiorenal effects of sotagliflozin in 
type 2 diabetes had not been explored until recently, when the results of 
SOLOIST-WHF (focusing on heart failure [HF] outcomes) and SCORED (focusing on 
renal outcomes) were published. In SOLOIST-WHF, sotagliflozin reduced the risk 
of the primary composite outcome of cardiovascular (CV) death and 
hospitalizations and urgent visits for HF. The findings showed that the risk 
reduction was consistent in people with reduced but also in those with preserved 
ejection fraction (EF). In SCORED, sotagliflozin significantly reduced the 
primary end point of CV deaths, hospitalizations for HF, and urgent visits for 
HF. A reduction in glycated hemoglobin was evident even in participants with 
estimated glomerular filtration rate values below 30 mL/min/1.73 m2. SCORED is 
also the first trial to illustrate the benefits of the class across the full 
range of albuminuria. Moreover, the endpoint of stroke was significantly reduced 
by 34% in the sotagliflozin compared with the placebo group. The findings of the 
two studies provide novel insights into the clinical utility of SGLT2 
inhibitors, particularly with respect to the early initiation in stable HF, the 
benefits in HF with preserved EF, the glucose-lowering efficacy in people with 
severe renal impairment and their potential to improve atherosclerotic vascular 
disease, including stroke, outcomes.