Victoria Socha

DocwireNews

Recommendations from current guidelines call for the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors independently of glycemic control in patients with type 2 diabetes as well as those with chronic kidney disease, heart failure, or at high risk of cardiovascular disease.Researchers in Israel, led by Meltzer Cohen, MD, conducted a study designed to examine the association between long-term use of SGLT2 inhibitors versus dipeptidyl peptidase 4 (DPP4) inhibitors and kidney benefits in patients with type 2 diabetes as well as in a subgroup without evidence of cardiovascualr or kidney disease. Results of the study were reported in the Clinical Journal of the American Society of Nephrology.Using a large Israeli database, the researchers propensity score-matched patients with type 2 diabetes who initiated SGLT2 inhibitors or DPP4 inhibitors between 2015 and 2021 1:1 according to 90 parameters. The primary outcome of interest was a kidney-specific composite outcome of confirmed &ge;40% decline in estimated glomerular filtration rate (eGFR) or kidney failure. The kidney-or-death outcome included all-cause mortality.Cox proportional hazard regression models were used to assess the risks of outcomes. The between-group difference in eGFR slope was also examined. Analyses were repeated in the subgroup of patients without evidence of cardiovascular or kidney diseaseA total of 19,648 propensity score-matched patients were included. Of those 53% (n=10,467) had no evidence of cardiovascular or kidney disease. Median follow-up was 38 months.The composite kidney-specific outcome occurred at an event rate of 6.9 events per 1000 patient-years with SLGT2 inhibitors versus 9.5 events per 1000 patient-years with DPP4 inhibitors. The event rates of the kidney-or-death outcome were 17.1 with SGLT2 inhibitors versus 22.1 with DPP4 inhibitors.Compared with DPP4 inhibitors, initiation of SGLT2 inhibitors was associated with a lower risk for both the kidney-specific outcome (hazard ratio [HR], 0.72; 95% CI, 0.61-0.86; P&lt;.001) and the kidney-or-death outcome (HR, 0.80; 95% CI, 0.71-0.89; P&lt;.001). In the subgroup of patients without evidence of cardiovascular or kidney disease, the respective HRs were 0.67 (95% CI, 0.44-1.02) and 0.77 (95% CI, 0.61-0.97).In the overall cohort, there was an association between initiation of SGLT2 inhibitors and a mitigation of the eGFR slope compared with initiation of DPP4 inhibitors. The association remained in the subgroup of patients without evidence of cardiovascular or kidney disease.In conclusion, the authors said, &ldquo;Long-term use of SGLT2 inhibitors versus DPP4 inhibitors in a real-world setting was associated with mitigation of eGFR loss in patients with type 2 diabetes, even in those lacking evidence of cardiovascular or kidney disease at baseline.&rdquo;&nbsp;Source: <a href="https://journals.lww.com/cjasn/fulltext/2023/09000/long_term,_real_world_kidney_outcomes_with_sglt2i.10.aspx" target="_blank" rel="noopener">Clinical Journal of the American Society of Nephrology</a>

Jordana Jampel

Successful HIV Viral Suppression With At-Home Administration

Modernization and the Rising Burden of IBD: New Insights From a Global Study

Gastroenterology

FDA Approves Novel Blood Test for Alzheimer’s Detection

Dementia

Latest News

Renal Outcomes With SGLT2 Inhibitors in Patients With Type 2 Diabetes

Part of NephTimes Diseases and Conditions

Diabetes and Hypertension

Assessing the association between long-term use of SGLT2 inhibitors versus DPP4 inhibitors and kidney benefits in patients with type 2 diabetes.

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe