Kidney outcomes with SGLT2is for type 2 diabetes patients: does background treatment with metformin or RASis matter?

Autor:	Chong KS; Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Chang YH; Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Department of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Lin MH; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan., Hsu CN; Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.; College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan., Wang CC; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan., Wang CY; College of Medicine, National Taiwan University, Taipei, Taiwan.; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Huang YL; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan., Lin FJ; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan., Ou HT; Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Department of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Jazyk:	angličtina
Zdroj:	Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2024 Jun 27; Vol. 15, pp. 1329945. Date of Electronic Publication: 2024 Jun 27 (Print Publication: 2024).
DOI:	10.3389/fendo.2024.1329945
Abstrakt:	Introduction: There is a lack of real-world evidence regarding the impact of concomitant metformin and renin-angiotensin system inhibitors (RASis) on sodium-glucose cotransporter-2 inhibitor (SGLT2i)-associated kidney outcomes. This study was aimed to investigate whether SGLT2i-associated kidney outcomes were modified by the concomitant use of metformin or RASis in patients with type 2 diabetes. Methods: SGLT2i users were identified from three electronic health record databases during May 2016 and December 2017 and categorized into those with and without concomitant use of metformin or RASis. Propensity score matching was performed to minimize baseline differences between groups. Study outcomes were mean estimated glomerular filtration rate (eGFR) change and time to 30%, 40%, and 50% eGFR reductions. A meta-analysis was performed to combine the estimates across databases. Results: After matching, there were 6,625 and 3,260 SGLT2i users with and without metformin, and 6,654 and 2,746 SGLT2i users with and without RASis, respectively. The eGFR dip was similar in SGLT2i users with and without metformin therapy, but was greater in SGLT2i users with RASis compared to those without RASis. Neither metformin nor RASi use had a significant effect on SGLT2i-associated eGFR reductions, as evidenced by the hazard ratios (95% CIs) of 30% eGFR reductions for SGLT2is with versus without metformin/RASis, namely 1.02 (0.87-1.20)/1.09 (0.92-1.31). Such findings were also observed in the outcomes of 40% and 50% eGFR reductions. Conclusion: Using metformin or RASis did not modify SGLT2i-associated kidney outcomes in type 2 diabetes. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Chong, Chang, Lin, Hsu, Wang, Wang, Huang, Lin and Ou.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu