Dapagliflozin (Farxiga) turned into once renoprotective and cardioprotective in patients with most causes of kidney illness with or with out kind 2 diabetes, a secondary analysis of the DAPA-CKD trial came across.
In one more witness on the over 4,300 patients from the distinctive trial, once-each day treatment with 10 mg of dapagliflozin very much diminished the likelihood for the composite of a sustained decline in eGFR of 50% or more, conclude-stage kidney illness, or death from cardiovascular or kidney causes — the necessary endpoint — no topic the underlying motive in the help of kidney illness (hazard ratio [HR] 0.61, 95% CI 0.51-0.72), stated David Wheeler, MD, of the George Institute for World Health in Sydney, Australia, throughout a presentation on the American Society of Nephrology’s virtual Kidney Week.
And when broken down by etiology of kidney illness, dapagliflozin very much diminished the likelihood for this composite necessary endpoint in patients whose kidney illness turned into once precipitated by diabetic nephropathy (HR 0.63, 95% CI 0.51-0.78) and glomerulonephritides (HR 0.43, 95% CI 0.26-0.71) in comparison with placebo.
On the other hand, patients whose kidney illness turned into once precipitated by ischemic/hypertensive chronic kidney illness (CKD; HR 0.75, 95% CI 0.44-1.26) or precipitated by totally different or unknown causes (HR 0.58, 95% CI 0.29-1.19) did no longer see a indispensable merit with dapagliflozin.
In an further analysis of 270 patients with IgA nephropathy, there turned into once a 71% diminished likelihood for this necessary endpoint with dapagliflozin versus placebo over a 32-month follow-up interval (HR 0.29, 95% CI 0.12-0.73).
“As we private already viewed from this understand in patients with chronic kidney illness with and with out kind 2 diabetes, dapagliflozin diminished the likelihood of kidney failure, diminished the likelihood of death from cardiovascular causes or hospitalization for coronary heart failure, and prolonged survival,” Wheeler pointed out.
“On this pre-specified analysis, we private shown that these renal-cardiovascular mortality benefits are present no topic the underlying motive in the help of chronic kidney illness and no topic the presence or absence of kind 2 diabetes,” he renowned.
Identical findings had been reported when entirely having a witness at renal-particular outcomes, outlined as a sustained 50% or more eGFR decline, development to conclude-stage kidney illness, or renal death. Overall, there turned into once a 44% diminished likelihood for this final consequence with dapagliflozin versus placebo (HR 0.56, 95% CI 0.45-0.68).
For those whose kidney illness turned into once precipitated by diabetic nephropathy, there turned into once a 45% diminished likelihood for this composite renal final consequence (HR 0.55, 95% CI 0.43-0.71), while those whose kidney illness turned into once precipitated by glomerulonephritides saw a 57% diminished likelihood for this renal final consequence with dapagliflozin (HR 0.43, 95% CI 0.26-0.72).
As soon as more, patients whose kidney illness turned into once namely precipitated by ischemic or hypertensive CKD (HR 0.74, 95% CI 0.40-1.36) or totally different/unknown causes (HR 0.81, 95% CI 0.35-1.83) did no longer see a indispensable diminished likelihood for this renal final consequence with dapagliflozin versus placebo.
When having a witness entirely at cardiovascular outcomes, entirely those whose kidney illness turned into once precipitated by diabetic nephropathy saw an extraordinarily much diminished likelihood for cardiovascular death or hospitalization for coronary heart failure with dapagliflozin (HR 0.67, 95% CI 0.50-0.90). Sufferers with all totally different underlying kidney illness etiologies did no longer see a indispensable cardiovascular merit.
Within the the same vein, entirely those with diabetic nephropathy saw an extraordinarily much diminished likelihood for all-impart off mortality (HR 0.72, 95% CI 0.54-0.97).
One limitation to this understand, nonetheless, turned into once the exclusion of patients with kind 1 diabetes, which Wheeler stated turned into once attributable to issues about safety and the with out doubt elevated likelihood for diabetic ketoacidosis in this inhabitants.
All 4,304 participants in the DAPA-CKD trial had chronic kidney illness with an eGFR of 25 to 75 mL/min/1.73m2 and a urine albumin-to-creatinine ratio of 200 to five,000 mg/g.
Disclosures
The understand turned into once funded by AstraZeneca.
Wheeler reported relationships with University School London, Amgen, AstraZeneca, Boehringer Ingelheim, Janssen, Napp, Mundipharma, GlaxoSmithKline, Gilead, Tricida, Vifor Fresenius, Astellas, Merck Sharpe and Dohme, Ono Pharma, Reata, George Institute for World Health, and the Kidney Health Initiative. Other co-authors moreover reported disclosures.
