Determinants of effects of SGLT2i on progression of CKD: Further results from the EMPA-KIDNEY trial - 20/09/23
Resumen |
Introduction |
In EMPA-KIDNEY, empagliflozin slows the progression of CKD among a wide spectrum of CKD-patients, but the empagliflozin effects on annual rate of eGFR change seems modified by key subgroups: baseline diabetes status, eGFR & uACR. However, it is not known whether some of this effect modification may be due to correlation with other key subgroups.
Methods |
The annual rate of eGFR change (slope) was a prespecified exploratory outcome in EMPA-KIDNEY. Shared parameter models are used to estimate absolute and relative effects of empagliflozin on chronic slopes in subgroups of interest using all available eGFR values from centrally measured creatinine. Analyses in key subgroups were conducted before and after inclusion of interactions with other key subgroups.
Results |
Overall, compared to placebo, empagliflozin halved the rate of progression (chronic slope reduced from 2.75 to 1.37mL/min/1.73m2/year). The absolute difference (AD) vs. placebo on chronic slopes, before including interactions with other key subgroups, was 1.68 (1.36–2.00) in T2D patients and 1.09 (0.79–1.39) mL/min/1.73m2 (P=0.0085) in patients without T2D. After including interactions, AD was 1.81 (1.51–2.11) in T2D and 1.03 (0.75–1.32) mL/min/1.73m2 (P=0.0003) without T2D.
The AD was largest among participants with higher uACR and eGFR but not modified after including interactions.
The relative difference was largest among participants with T2D, lower eGFR, UACR but not modified after including interactions.
Conclusion |
Differences in the absolute effect of empagliflozin on chronic eGFR slope by baseline diabetes status, eGFR, uACR are not explained by baseline differences in other key baseline characteristics.
El texto completo de este artículo está disponible en PDF.Esquema
Vol 84 - N° 5
P. 549 - octobre 2023 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
¿Ya suscrito a @@106933@@ revista ?