AHA 2022: SGLT-2I reduces cardiovascular risk in adults with chronic kidney disease

Research Highlights:

The data is planned to be published
simultaneously in The Lancet.

According to the latest research presented today at the American Heart Association's 2022 Scientific Meeting, SGLT-2 inhibitors are diabetes medications that reduce cardiovascular risk
in adults with chronic kidney disease.

"Many studies of empagliflozin and other similar drugs called SGLT-2 inhibitors (sodium-glucose cotransporter-2 inhibitors) have shown that these drugs are safe for people with type 2 diabetes," said co-principal investigator David Preiss, Ph.
D
.
Therefore, we hope that SGLT-2 inhibitors can be widely used in many countries to treat people
with these conditions.
”

The investigators combined the results of 13 major clinical trials of SGLT-2 inhibitors to consider the effects
on kidney disease progression, acute kidney injury and cardiovascular death or heart failure hospitalization in participants with or without type 2 diabetes.
According to Preiss, the analysis confirmed the important benefits of SGLT-2 inhibitors for major cardiovascular and renal disease outcomes:

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 studies have linked
this drug to a reduced risk of hospitalization for heart failure and a reduced risk of worsening kidney disease in people with type 2 diabetes.
"What is not clear is whether this drug may have the same protective effect in people who have not been diagnosed with type 2 diabetes," Preiss said
.

EMPA-KIDNEY researchers recruited 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, and more than half of them 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% of people have cardiovascular disease; Slightly less than half have type 2 diabetes
.
Between May 2019 and April 2021, participants were randomly assigned to either empagliflozin or placebo
.
Follow-up averaged two years
.

The results of the EMPA-KIDNEY trial, published two days ago on November 4, 2022, showed a 28% reduction in the risk of exacerbations of kidney disease and death from cardiovascular disease in participants in the empagliflozin group, for those with or without type 2 diabetes
.
The incidence of cardiovascular events is lower than expected
.
Although the reduction in major cardiovascular events with empagliflozin treatment was not statistically significant in the trials, the results of these results were fully consistent with
those of other trials.

"Our findings suggest that SGLT-2 inhibitors, such as empagliflozin, should be offered to all adults who may benefit from treatment to reduce the risk of kidney disease progression and cardiovascular complications in patients with chronic kidney disease, regardless of whether they have type 2 diabetes or not," Preiss said
.

Co-authors are William Herrington, MD, and Richard Haynes, MD, who represent the Oxford Population Healthy Kidney Research Group and the SGLT2 Consortium for Meta-Analytical Heart and Kidney Trials (SMART-C).

The author's disclosures
are listed in the abstract.

The research was funded
by core funding from the UK Medical Research Council to the Oxford Medical Research Council's Population Health Research Unit.
EMPA-KIDNEY is funded
by Boehringer Ingelheim and Eli Lilly and Company.

Resources:

https://newsroom.
heart.
org/news/diabetes-medicine-decreased-cardiovascular-risk-in-adults-with-chronic-kidney-disease