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bosentan + dapagliflozin is an investigational combination therapy being evaluated for the treatment of large vessel vasculitis (LVV). The combination consists of two small molecule active ingredients: bosentan, a dual endothelin receptor antagonist, and dapagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor. This therapeutic approach, spearheaded by the University of Edinburgh, is currently being studied in the Phase 2 DERAIL-LVV trial to assess its impact on endothelial function and arterial stiffness in patients with LVV in remission. By blocking endothelin receptors, bosentan aims to reduce vessel stiffness and blood pressure, while dapagliflozin provides additional vascular protection and may help mitigate the fluid retention often associated with endothelin receptor antagonists. The combination is intended to address the heightened cardiovascular risk in patients with chronic inflammatory vascular disease.
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