Empagliflozin Slows Kidney Disease in Type 2 Diabetes Patients
Empagliflozin (EMPA) use is associated with a lower risk for a rapid decline in estimated glomerular filtration rate (eGFR) among patients with type 2 diabetes, according to a recent analysis.
Findings were presented at the American Society of Nephrology’s Kidney Week 2017, which is taking place from October 31 to November 5, 2017, in New Orleans, Louisiana.
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eGFR is known to progressively decline in most patients with type 2 diabetes. When a more rapid decline in eGFR occurs, the risks for uremia and end-stage renal disease are increased. However, in the EMPA-REG OUTCOME trial, EMPA use was associated with a slower progression of kidney disease.
For their analysis, the researchers evaluated 7020 patients with type 2 diabetes and established cardiovascular disease (CVD) who had participated in the EMPA-REG OUTCOME trial. Patients had a baseline mean eGFR of 74.0 ml/min/1.73m2. Patients were randomly assigned to receive 10 mg EMPA, 25 mg EMPA, or placebo, in addition to standard of care.
Linear regression models were used to determine the change in eGFR decline from baseline to follow-up. A rapid decline in eGFR was defined by a yearly decline in eGFR of at least 5 ml/min/1.73m2. Differences between EMPA and placebo groups were examined via logistic regression analysis.
Results indicated that 354 (5.1%) patients had experienced a rapid decline in eGFR. Of these patients, 8.9% had received placebo, and 3.2% had received EMPA. Following adjustment for other risk factors, the researchers found that EMPA use was associated with a two-thirds reduced risk of rapid eGFR decline. Additionally, patients using a lower threshold of EMPA had experienced a similar reduction in rapid decline in eGFR.
“Patients treated with EMPA were significantly less likely to experience a rapid decline in eGFR over approximately 3 years of treatment,” the researchers concluded. “This finding suggests that EMPA may have the potential to reduce the incidence of chronic renal failure in [type 2 diabetes] in the long term.”
—Christina Vogt
Reference:
Hadjadj S, Thomas MC, Cooper ME, et al. Empagliflozin (EMPA) and incidence of rapid decline in eGFR in patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD): an exploratory analysis from the EMPA-REG OUTCOME Trial. Paper presented at: American Society of Nephrology Kidney Week 2017; October 31-November 5, 2017; New Orleans, LA. https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2783673.