A small study found that empagliflozin, a diabetes medication, reduced certain inflammatory cell clusters in the blood.
The changes appeared within two weeks and became more pronounced after three months of treatment.
Researchers say the findings could help explain how the drug may benefit heart health beyond its effects on blood sugar and weight.
A popular diabetes medication may offer another potential benefit: reducing inflammation linked to cardiovascular disease.
In a human trial, researchers found that empagliflozin, part of a class of drugs called SGLT2 inhibitors, reduced certain combinations of immune and blood-clotting cells associated with inflammation in blood vessels.
Inflammation is part of the body's normal defense system, but when it persists or affects blood vessels, it can contribute to cardiovascular problems. Understanding how medications influence this process could help researchers learn more about their potential heart-protective effects.
The findings, published in the journal Circulation, provide early evidence that empagliflozin may affect the immune system in ways that go beyond its established blood sugar-lowering effects.
“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,” Mona Mashayekhi, MD, PhD, Assistant Professor of Medicine in the Division of Diabetes, Endocrinology and Metabolism at Vanderbilt Health, said in a news release. “This study provides the first direct evidence of SGLT2 inhibitors altering human immune cells which may potentially 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 and 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.”
How the study was conducted
The research team, led by investigators at Vanderbilt Health, enrolled 16 women with obesity and prediabetes. Participants took empagliflozin for three months, with researchers measuring changes in their blood before treatment, after two weeks, and after 12 weeks.
The team also examined a comparison group of women who followed a low-calorie diet for three months. This allowed researchers to explore whether changes in inflammation might be related to the medication itself rather than weight loss alone.
Using genetic sequencing and cellular imaging, researchers looked closely at immune cells and their interactions with other blood cells. One focus was monocyte-platelet aggregates, or MPAs. These form when monocytes, a type of immune cell, attach to platelets, which help blood clot. These cell clusters are associated with inflammation in blood vessels and cardiovascular disease.
What the results could mean for consumers
Women who took empagliflozin experienced a significant reduction in MPAs within two weeks, and the decrease was even greater after 12 weeks. The researchers did not observe the same reduction in the comparison group following a low-calorie diet.
The team also found that the participants' monocytes shifted away from a highly inflammatory state toward a more stable pattern of cellular energy use. Together, these findings suggest the medication may influence inflammation through changes in immune cells, rather than simply through weight loss.
However, the study was small and included only women with obesity and prediabetes. It does not establish that taking empagliflozin will prevent heart attacks or other cardiovascular events. More research is needed to understand how these cellular changes translate into meaningful health benefits.
Researchers at Vanderbilt have begun a larger, randomized, placebo-controlled trial involving 74 people with obesity and metabolic syndrome. That study will investigate these immune changes further and examine fat tissue to better understand inflammation.
For consumers, the findings offer a promising new direction for research, but they are not a reason to start or change medication without consulting a healthcare professional.