Pooled analysis of Phase III trials indicate contrasting influences of renal function on blood pressure, body weight, and HbA1c reductions with empagliflozin
| Autor: | Ilkka Tikkanen, David Z.I. Cherney, Hans-Juergen Woerle, Søren S Lund, Egon Pfarr, Mark E. Cooper, Odd Erik Johansen, Uli C. Broedl |
|---|---|
| Přispěvatelé: | Department of Medicine, Clinicum |
| Rok vydání: | 2018 |
| Předmět: |
CHRONIC KIDNEY-DISEASE
Male Blood Pressure Type 2 diabetes 030204 cardiovascular system & hematology PLACEBO-CONTROLLED TRIAL Kidney Diabetic nephropathy DOUBLE-BLIND 0302 clinical medicine Glucosides ADD-ON Weight loss SGLT2 inhibition Medicine Diabetic Nephropathies Randomized Controlled Trials as Topic CARDIOVASCULAR RISK SALT SENSITIVITY AORTIC STIFFNESS Middle Aged kidney diseases 3. Good health Treatment Outcome Nephrology Female medicine.symptom ARTERIAL STIFFNESS Glomerular Filtration Rate Adult medicine.medical_specialty Ambulatory blood pressure Urology TYPE-2 DIABETES-MELLITUS Down-Regulation Renal function 030209 endocrinology & metabolism 03 medical and health sciences Internal medicine Weight Loss Empagliflozin Humans Benzhydryl Compounds Renal Insufficiency Chronic Sodium-Glucose Transporter 2 Inhibitors Aged Glycated Hemoglobin COTRANSPORTER 2 INHIBITION business.industry diabetic nephropathy medicine.disease Endocrinology Blood pressure Clinical Trials Phase III as Topic Diabetes Mellitus Type 2 3121 General medicine internal medicine and other clinical medicine business Biomarkers Kidney disease |
| Zdroj: | Kidney International. 93:231-244 |
| ISSN: | 0085-2538 |
| DOI: | 10.1016/j.kint.2017.06.017 |
| Popis: | Sodium glucose cotransporter 2 (SGLT2) inhibitors reduce HbA1c, blood pressure, and weight in patients with type 2 diabetes. To investigate the effect of renal function on reductions in these parameters with the SGLT2 inhibitor empagliflozin, we assessed subgroups by baseline estimated glomerular filtration rate (eGFR; Modification of Diet in Renal Disease) in pooled data from five 24-week trials of 2286 patients with type 2 diabetes randomized to empagliflozin or placebo. Reductions in HbA1c with empagliflozin versus placebo significantly diminished with decreasing baseline eGFR. Reductions in systolic blood pressure (SBP) with empagliflozin were maintained in patients with lower eGFR. The mean placebo-corrected changes from baseline in systolic blood pressure at week 24 with empagliflozin were -3.2 (95% confidence interval -4.9,-1.5) mmHg, -4.0 (-5.4, -2.6) mmHg, -5.5 (-7.6, -3.4) mmHg, and -6.6 (-11.4, -1.8) mmHg in patients with an eGFR of 90 or more, 60 to 89, 30 to 59, and under 30 ml/min/1.73m(2), respectively. Similar trends were observed for diastolic blood pressure. Weight loss with empagliflozin versus placebo tended to be attenuated in patients with a lower eGFR. Results were consistent in a 12-week ambulatory blood pressure monitoring trial in 823 patients with type 2 diabetes and hypertension. Thus, unlike HbA1c reductions, systolic blood pressure and weight reductions with empagliflozin are generally preserved in patients with chronic kidney disease. |
| Databáze: | OpenAIRE |
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