DIABETIC KIDNEY DISEASE

Organ protection beyond glycaemic control with SGLT2 inhibitors

Recent clinical trials demonstrated that sodium–glucose co-transporter 2 inhibitors can reduce hospitalization for heart failure and improve hard kidney end points in patients with and without type 2 diabetes mellitus. These observations consolidate the view that organ protection is independent of blood glucose control and mitigation of traditional risk factors.

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Fig. 1: Clinical trials expand the populations that benefit from SGLT2 inhibition.

References

  1. 1.

    Zinman, B. et al. Empagliflozin, Cardiovascular outcomes, and mortality in type 2 diabetes. N. Engl. J. Med. 373, 2117–2128 (2015).

    CAS  Article  Google Scholar 

  2. 2.

    Neal, B. et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N. Engl. J. Med. 377, 644–657 (2017).

    CAS  Article  Google Scholar 

  3. 3.

    Wiviott, S. D. et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med. 380, 347–357 (2019).

    CAS  Article  Google Scholar 

  4. 4.

    Perkovic, V. et al. Canagliflozin and renal outcomes in patients with type 2 diabetes and nephropathy. N. Engl. J. Med. 380, 2295–2306 (2019).

    CAS  Article  Google Scholar 

  5. 5.

    McMurray, J. J. V. et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N. Engl. J. Med. 381, 1995–2008 (2019).

    CAS  Article  Google Scholar 

  6. 6.

    Packer, M. et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N. Engl. J. Med. 383, 1413–1424 (2020).

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Heerspink, H. J. L. Dapagliflozin in patients with chronic kidney disease. N. Engl. J. Med. 383, 1436–1446 (2020).

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Zannad, F. et al. SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. Lancet 396, 819–829 (2020).

    Article  PubMed  Google Scholar 

  9. 9.

    Pardeep S Circulation. Efficacy of dapagliflozin on renal function and outcomes in patients with heart failure with reduced ejection fraction: results of DAPA-HF https://doi.org/10.1161/CIRCULATIONAHA.120.050391 (2020).

  10. 10.

    Anker, S. D. et al. Evaluation of the effects of sodium-glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality in patients with chronic heart failure and a preserved ejection fraction: rationale for and design of the EMPEROR Preserved Trial. Eur. J. Heart Fail. 21, 1279–1287 (2019).

    CAS  Article  Google Scholar 

Download references

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Correspondence to Carol Pollock.

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C.P. is an Advisory Board member for Astra Zeneca and Boehringer Ingelheim, and a member of the Steering Committee of CREDENCE. U.P. declares no competing interests.

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Panchapakesan, U., Pollock, C. Organ protection beyond glycaemic control with SGLT2 inhibitors. Nat Rev Nephrol (2020). https://doi.org/10.1038/s41581-020-00373-4

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