Health
SGLT2 inhibitors are associated with reduced risk of serious renal events
New data from sodium glucose cotransporter 2 (SGLT2) inhibitors show more severe renal effects than dipeptidyl peptidase 4 (DPP4) inhibitors in patients with type 2 diabetes and varying levels of renal function in real-world patients. Associated with low risk of events Sweden, Denmark, Norway.
Investigators used national registry data to identify 29,887 new users of SLGT2 inhibitors for trend variable scores (mostly dapagliflozin and empagliflozin; use of canagliflozin was rare) and 57 variables for DPP. -We compared 29,887 new users of -4 inhibitors. Use of SGLT2 inhibitors was significantly associated with a 58% reduction in relative risk of severe renal disease (renal replacement therapy complex) [RRT], Death due to renal disease, and hospitalization for renal events) and absolute risk reduction of 3.6 events per 1000 person-years (2.6 vs. 6.2 events per 1000 person-years respectively), Peter Ueda, MD, PhD, Karolinska Institute in Stockholm, Sweden, And collaborators BMJ. According to the individual components of the composite endpoint, the use of SGLT2 inhibitors significantly reduced the hospitalization risk of RRT and renal events by 68% and 59%, respectively, and the insignificant 23% reduction in death from renal disease. It was related. The corresponding absolute risk reduction was -1.7 vs -2.9 vs -0.1 events per 1000 person years, respectively.
Within subgroup
Analysis, SGLT2-related composite endpoint risk reduction
Inhibitors were significantly higher in patients than in chronic patients
From people without renal disease (70% vs 48%) and cardiovascular disease
Disease (82% vs 48%).
“The absolute risk reduction associated with
SGLT2 inhibitor was greater in patients with cardiovascular disease or chronic
There was also a protective association of kidney disease and SGLT2 inhibitors
It was observed in patients without such history, “said Dr. Ueda’s team.
”
Findings from this observational study complement clinical data
Previous observational studies on trials and cardiovascular outcomes,
Further support the use of a wide range of SGLT2 inhibitors
Range of type 2 diabetic patients with varying levels of renal function. “
To
Sensitivity analysis, protective effect of SGLT2 inhibitor appeared
Hyperglycemia control, low blood pressure, independent of body weight
loss. According to the authors, SGLT2 inhibitors
It can reduce renal hemodynamics and tissue inflammation and fibrosis.
In an accompanying editorial, Stephen M. Smith, PharmD, MPH at the University of Florida Gainesville commended the study, admitting it was observable and susceptible to confounding.
“Overall,
The findings of Pastel Nac and his colleagues
SGLT2 inhibitor. Additional practical comparative efficacy testing
The world environment and more diverse population
Wider access to these drugs is not only found in high-income countries,
Low-income countries with disproportionate burden of kidney disease
high. “
Disclosure: Several research authors
Declared a partnership with the pharmaceutical industry. See the original
See complete list of author disclosures.
References
Pasternak B, Winzel V, Melby M, etc. Use of Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Serious Renal Events: A Scandinavian Cohort Study [published April 29, 2020]. BMJ 2020; 369: m1186. Doi: 10.1136 / bmj.m1186
Smith SM. Real-world SGLT2 inhibitors and renal outcomes: Observational data from clinical practice favors these drugs over DPP4 inhibitors [published April 29, 2020]. BMJ 2020; 369: m1584. Doi: 10.1136 / bmj.m1584
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