Pooled analysis of Phase III trials indicate contrasting influences of renal function on blood pressure, body weight, and HbA1c reductions with empagliflozin

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Cherney , D Z I , Cooper , M E , Tikkanen , I , Pfarr , E , Johansen , O E , Woerle , H J , Broedl , U C & Lund , S S 2018 , ' Pooled analysis of Phase III trials indicate contrasting influences of renal function on blood pressure, body weight, and HbA1c reductions with empagliflozin ' , Kidney International , vol. 93 , no. 1 , pp. 231-244 . https://doi.org/10.1016/j.kint.2017.06.017

Title: Pooled analysis of Phase III trials indicate contrasting influences of renal function on blood pressure, body weight, and HbA1c reductions with empagliflozin
Author: Cherney, David Z. I.; Cooper, Mark E.; Tikkanen, Ilkka; Pfarr, Egon; Johansen, Odd Erik; Woerle, Hans J.; Broedl, Uli C.; Lund, Soren S.
Contributor: University of Helsinki, Department of Medicine
Date: 2018-01
Language: eng
Number of pages: 14
Belongs to series: Kidney International
ISSN: 0085-2538
URI: http://hdl.handle.net/10138/298514
Abstract: 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.
Subject: diabetic nephropathy
glomerular filtration rate
kidney diseases
SGLT2 inhibition
TYPE-2 DIABETES-MELLITUS
PLACEBO-CONTROLLED TRIAL
CHRONIC KIDNEY-DISEASE
COTRANSPORTER 2 INHIBITION
ARTERIAL STIFFNESS
DOUBLE-BLIND
ADD-ON
CARDIOVASCULAR RISK
SALT SENSITIVITY
AORTIC STIFFNESS
3121 General medicine, internal medicine and other clinical medicine
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