Diabetes medication reduces the risk of cardiovascular disease in adults with chronic kidney disease

Research Highlights:

  • A new analysis found that inhibitors of SGLT-2, a diabetes drug, reduced the risk of cardiovascular death and hospitalization due to heart failure, in high-risk patients regardless of whether they had type 2 diabetes.

  • Pooled results from 13 main trials of empagliflozin and similar drugs showed that study participants who received an SGLT-2 inhibitor were 14% less likely to die from cardiovascular disease. Participants treated with these drugs were 23% less likely to die from cardiovascular disease or be hospitalized with heart failure than participants who took a placebo.

This data is scheduled to be published simultaneously in The Lancet.

Banned until 5:26 PM ET / 6:26 PM ET, Sunday, November 6, 2022

(NewMediaWire) — Nov 06, 2022 — CHICAGO SGLT-2 inhibitors, a type of diabetes drug, lowered cardiovascular disease risk among adults with chronic kidney disease, according to the latest research presented today at the 2022 American Heart Association Scientific Sessions. The meeting, held in person in and around Chicago, November 5-7, 2022, is a major global exchange of the latest scientific advances, research, and evidence-based clinical practice updates in the cardiovascular sciences.

Co-principal investigator David Preiss, Ph.DV. PhD, Associate Professor in the Population Health Research Unit at the University of Oxford Medical Research Council, Oxford Population Health UK “And we now have very good evidence that it reduces the chance of death from vascular disease or hospitalization for heart failure among people with CKD. Or heart failure or type 2 diabetes and cardiovascular disease. So we hope that SGLT-2 inhibitors will be widely used to treat people with these conditions in many countries.”

The researchers pooled the results of 13 major clinical trials of SGLT-2 inhibitors to look at the effects on the progression of kidney disease, acute kidney injury, and cardiovascular death or hospitalization due to heart failure in participants with or without type 2 diabetes. According to Press, the analysis confirmed the important benefits of SGLT-2 inhibitors on major cardiovascular and renal disease outcomes:

  • SGLT-2 inhibitors reduced the risk of cardiovascular death by 14%, with similar results among participants with or without type 2 diabetes.

  • SGLT-2 inhibitors also reduced the risk of cardiovascular death or hospitalization from heart failure by 23%, with similar results among participants with or without type 2 diabetes.

  • Kidney disease risk was reduced by 37% overall, again with similar effects among participants regardless of type 2 diabetes status.

  • Based on trial data, for every 1,000 participants with heart failure treated for a year, 34 diabetics and 22 diabetics avoided cardiovascular death or hospitalization for heart failure.

  • Of every 1,000 participants with chronic kidney disease treated for a year, 11 with prediabetes and 15 with prediabetes avoided exacerbation of kidney disease.

The meta-analysis included results from the EMPA-KIDNEY trial, the largest study evaluating the use of SGLT-2 inhibitors in participants with chronic kidney disease. Previous research has linked the drug to a lower risk of hospitalization heart failure And a lower risk of worsening kidney disease among people with type 2 diabetes. “What remains unclear is whether this drug might have the same protective effect among people who haven’t been diagnosed with type 2 diabetes,” Price said.

EMPA-KIDNEY researchers enrolled 6,609 study participants in eight countries: Germany, the United States, the United Kingdom, China, Malaysia, Japan, Canada and Italy. The average age of the participants was 64 years, and more than half were white adults, 36% were Asian adults and 4% were black adults. All participants had evidence of kidney disease for at least 3 months. More than 25% suffer from cardiovascular disease. Just under half had type 2 diabetes. Between May 2019 and April 2021, participants were randomly assigned to either empagliflozin or a placebo. Follow-up was an average of two years.

The results of the EMPA-KIDNEY trial, published two days ago on November 4, 2022, showed that among participants in the empagliflozin group, the risk of exacerbation of renal disease and death from cardiovascular disease was reduced by 28%, with similar benefits for participants with cardiovascular disease . or without type 2 diabetes. The rate of cardiovascular events was lower than expected. Although the reduction in major cardiovascular events with empagliflozin treatment was not statistically significant in the trial, the results of these findings were fully consistent with those of the other trials.

“Our results suggest that all adults who may benefit from treatment should be offered SGLT-2 inhibitors such as empagliflozin, to reduce the risk of developing kidney disease and cardiovascular complications in people with CKD, regardless of whether they have type 2 diabetes,” Press said. or not”.

The co-authors are William Herrington, MD, and Richard Haynes, DM, on behalf of the Oxford Group for Kidney and Kidney Health Studies and the SGLT2 Group for Heart and Kidney Meta-Analysis (SMART-C). The authors’ disclosures are listed in the abstract.

The study was funded with seed funding for the Population Health Research Unit at the University of Oxford Medical Research Council from the UK Medical Research Council. EMPA-KIDNEY was funded by Boehringer Ingelheim and Eli Lilly and Company.

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Additional resources:

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