Studies with SGLT2 inhibitors primarily focused on renal parameters in patients with chronic kidney disease with/without type 2 diabetes mellitus

Česká verzia

Authors: Zbynek Schroner
Authors place of work: SchronerMED s. r. o., Košice
Published in the journal: Diab Obez 2021; 21(41): 35-38
Category: Clinical studies

Summary

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 HbA_1c target.

Keywords:

canagliflozin – dapagliflozin – empagliflozin – study CREDENCE – study DAPA-CKD –study EMPA-KIDNEY

Zdroje

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>.