Studies with SGLT2 inhibitors primarily focused on renal parameters in patients with chronic kidney disease with/without type 2 diabetes mellitus
Authors:
Zbynek Schroner
Authors‘ workplace:
SchronerMED s. r. o., Košice
Published in:
Diab Obez 2021; 21(41): 35-38
Category:
Overview
At present are ongoing or finished some clinical studies with SGLT2 inhibitors primarely focused on renal outcomes in patients with chronic kidney disease (CKD) with or without type 2 diabetes mellitus. Canagliflozin in CREDENCE study in patients with type 2 diabetes mellitus and CKD stages 2–3b reduced risk of primary renal outcome (doubling of the serum creatinine level, end-stage kidney disease, death from renal or cardiovascular causes) by 30 % in comparison with placebo. Occurence of primary outcome – progression of CKD (defined as sustained decline in the estimated GFR of ≥ 50 % or end-stage kidney disease), or death from cardiovascular or renal causes – was by administration of dapagliflozin in study DAPA-CKD in patients with or without type 2 diabetes decreased by 39 %. Study EMPA-KIDNEY with empagliflozin is still ongoing. Current ADA/EASD guidelines recommend SGLT2 inhibitors in patients with CKD and GF ≥ 0,5 ml/s or albuminuria (mainly macroalbuminuria) as second line therapy after metformin independently of baseline or individualised HbA1c target.
Keywords:
canagliflozin – dapagliflozin – empagliflozin – study CREDENCE – study DAPA-CKD –study EMPA-KIDNEY
Sources
- Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.
- Neal B, Perkovic V, Mahaffey KW et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med 2017; 377(7): 644–657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>.
- Wiviott SD, Raz I, Bonaca P et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N. Eng J Med 2019; 380(4): 347–357. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1812389>.
- Perkovic V, Jardine MJ, Neal B et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380(24): 2295–2306. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1811744>.
- Mahaffey KW, Jardine MJ, Bompoint S et al. Canagliflozin and cardiovascular and renal outcomes in type 2 diabetes mellitus and chronic kidney disease in primary and secondary cardiovascular prevention groups, results from the randomized CREDENCE trial. Circulation 2019; 140(9): 739–750. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.119.042007>.
- Jardine M, Zhou Z, Heerspink H et al. Renal, cardiovascular and safety outcomes of canagliflozin according to baseline albuminuria : a CREDENCE secondary analysis. Abu-Dhabi 26.-29.3. 2020. Kidney Int Rep 2020; 5(3, Suppl): Abstr SAT-156. Dostupné z DOI: <https://doi.org/10.1016/j.ekir.2020.02.166>.
- Neuen BL, Mahaffey KW, Cannon CP et al. Effects of canagliflozin on cardiovascular, renal and safety outcomes by baseline loop diuretic use: Data form the CREDENCE trial. 69th Annual Scientific Session American College of Cardiology. Chicago 28.-30.3. 2020. J Am Coll Cardiol 2020; 75(11, Suppl 1): 1852.
- Hiddo JL, Heerspink H, Bergur V et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med 2020; 383(15): 1436–1446. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2024816>.
- EMPA-KIDNEY (The Study of Heart and Kidney Protection with Empagliflozin). Dostupné z WWW: <https://clinicaltrials.gov/ct2/show/NCT03594110>.
- Invokana. Skrátená informácia o prípravku (SPC). Dostupné z WWW: <http://www.sukl.sk>.
- Mokáň M, Okša A, Galajda P. Nefroprotektívny účinok gliflozínov u pacientov s diabetickou obličkovou chorobou – výsledky štúdie CREDENCE. Interná Med 2019; 19(9): 325–328.
- Buse JB, Wexler DJ, Tsapas A et al. 2019 update to: Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2020; 43(2): 487–493. Dostupné z DOI: <http://dx.doi.org/10.2337/dci19–0066>.
- [Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group]. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2020; 98(4, Suppl): S1–S115. Dostupné z DOI: <http://dx.doi.org/10.1016/j.kint.2020.06.019>.
Labels
Diabetology ObesitologyArticle was published in
Diabetes a obezita
2021 Issue 41
Most read in this issue
- Discordance between blood glucose and HbA1c – is an explanation possible according to the biokinetic model of glycation?
- Today we can influence overweight and obesity – and thus prevent their consequences, as is the development of diabetes or cardiovascular disease
- The potential of induced pluripotent stem cells in the study and treatment of monogenic diabetes
- News in the field of 2nd generation of basal insulin analogs in type 1 diabetes and data from continuous glucose monitoring