Glucose-lowering drugs appear to slash the risk of organ failure and mortality in chronic kidney disease, which now is estimated to affect nearly 40% of people over the age of 60.
New studies show evidence that empagliflozin and dapagliflozin have significant effects on the rate of kidney decline and death. The medications belong to a relatively new class of drugs — SGLT2 inhibitors — recommended for people with type 2 diabetes who have poorly controlled blood glucose and high HbA1c levels.
In a phase 3 clinical trial, AstraZeneca’s Farxiga (dapagliflozin) dramatically prolonged survival in patients with CKD, the drugmaker reported Sunday. Specifically, Farxiga along with standard clinical care slowed the decline of renal function or the risk of cardiovascular or renal death by 39% compared with placebo. Earlier results from the same trial found that dapagliflozin also reduced cardiovascular deaths and slowed heart failure.
Meanwhile, a new investigation into empagliflozin found that it, too, slows progression of chronic kidney disease — even in people who do not have type 2 diabetes, the authors said.
The annual rate of decline in the estimated glomerular filtration rate, a sign of kidney health, was significantly slower in an empagliflozin group than in a placebo group, reported lead researcher Milton Packer, M.D., of Baylor University Medical Center at Dallas. Study participants treated with empagliflozin also had a lower risk of serious kidney outcomes.
The new findings have major implications for people with chronic kidney disease, according to researchers.
“[T]his is great news for patients with CKD,” said Christoph Wanner, M.D., Ph.D., co-author of a 2015 study that hinted at the current results. “For years, no new treatment option has proved to be safe and effective, which meant that no new drug could be introduced into clinical practice. We now have a whole new substance class that is obviously very effective.”
Diabetes is the leading cause of kidney failure, accounting for 44% of new cases, according to the National Kidney Foundation.