Charlotte Robinson

DocwireNews

Dapagliflozin is known to improve kidney outcomes in patients with chronic kidney disease (CKD), but it is unclear what effect late initiation of the drug has when eGFR is &lt;25 mL/min/1.73m2.
To improve understanding, Chi-Chih Hung, Yi-Wen Chiu, and Shang-Jyh Hwang studied the efficacy and safety of dapagliflozin in patients with CKD stages 4 and 5. They shared findings during the oral presentation, Efficacy and Safety of Dapagliflozin in Patients with CKD Stages 4-5 at ASN Kidney Week 2024.
The DAPA advKD trial (NCT05196347) was a randomized5p-, open-label trial that recruited 180 patients with eGFR 10-30 mL/min/1.73m2 and eGFR decline ≥2.5 mL/min/1.73m2/year. These patients were randomized 2:1 to dapagliflozin (5-10 mg/d) plus integrated CKD care, or integrated CKD care only.
The primary study outcome was maintenance of eGFR decline ≥0.75 ml/min/1.73m2/year. The first secondary outcome was renal endpoint (a composite of renal replacement therapy, eGFR &lt;5 mL/min/1.73m2, renal or cardiovascular [CV] death, or a &gt;50% eGFR decline). The second secondary outcome was renal and CV endpoint (a composite of renal outcome as defined above, acute kidney injury [AKI], and heart failure). Predefined safety outcomes were measured.
During a median period of 1.62 years, total eGFR slopes were -2.24 mL/min/1.73m2/year (-4.70 to -0.62 mL/min/1.73m2/year) for the dapagliflozin group and -3.67 mL/min/1.73m2/year (-7.16 to -1.25 mL/min/1.73m2/year) for the control group. The primary outcome of eGFR slope decline was 1.06 ml/min/1.73m2/year (0.10 to 0.32 ml/min/1.73m2/year; P=.019, linear mixed model).
The secondary renal outcome occurred in 24/120 (20%) patients in the dapagliflozin group, and in 21/60 (35%) in the control group (HR, 0.50 [0.28 to 0.89], P=.019). The secondary renal and CV outcome occurred in 25/120 (21%) patients in the dapagliflozin group and 21/60 (35.0%) in the control group (HR, 0.52 [0.29 to 0.93], P=.028). The control group experienced higher rates of heart failure and AKI but had a higher incidence of eGFR decline.
The researchers concluded, “Among patients with eGFR 10-30 mL/min/1.73m2, the risks of eGFR decline and composite renal outcomes were lower with dapagliflozin than with control group.”
Source: Hung C-C, Chiu Y-W, Hwang S-J. Efficacy and safety of dapagliflozin in patients with CKD stages 4-5. SA-OR96. Abstract of an oral presentation at the American Society of Nephrology Kidney Week 2024; October 26, 2024; San Diego, California. Funding was provided by AstraZeneca.

Emily Menendez

Complete Response to Immunotherapy in HCC: Insights From IMbrave150

Hepatocellular Carcinoma

Anne Marie Morse, DO

Rob Dillard

Dr. Morse Talks About the Significance of World Sleep Day 2025

Sleep Disorders

Dr. John Fruehauf, Evolent

Advancing Therapies Have Improved the Prognosis of Metastatic Melanoma

Melanoma

Latest News

Dapagliflozin Safety and Efficacy in Advanced CKD

ASN Kidney Week 2024

Researchers studied the efficacy and safety of dapagliflozin in patients with chronic kidney disease (CKD) stages 4 and 5.

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

Mesothelioma

Non-Small Cell Lung Cancer

Small Cell Lung Cancer

Lung Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe