This is consistent with findings from a previous trial on biliary cirrhotic rats, which demonstrated that empagliflozin exacerbated hepatic encephalopathy, as evidenced by decreased motor activity,23 suggesting that SGLT-2 inhibitors should be used with caution in patients with cirrhosis who are at an increased risk for hepatic encephalopathy. This evidence concerns the gene SLC5A2 and Cirrhosis.