The SONATA Trial: SGLT2 Inhibition as a New Frontier in HCM Treatment

In this episode of In the Thick of It, Dr. James MacNamara sits down with Dr. Sharlene Day, Director of Translational Research at the University of Pennsylvania, to discuss the groundbreaking SONATA trial. This double-blind, placebo-controlled clinical trial is evaluating the safety and efficacy of sotagliflozin—a dual SGLT1 and SGLT2 inhibitor—in patients with both obstructive and non-obstructive hypertrophic cardiomyopathy. Dr. Day details the trial's unique design, its primary endpoint of improving the Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and the fascinating metabolic mechanisms that may allow these drugs to reduce the heart's workload. The conversation also covers the safety protocols for monitoring outflow tract obstruction and the potential pleiotropic benefits of SGLT2 inhibitors beyond traditional heart failure management.