Kidney outcomes using a sustained ≥40% decline in eGFR: A meta-analysis of SGLT2 inhibitor trials

Cherney, David Z. I. and Dagogo-Jack, Samuel and McGuire, Darren K. and Cosentino, Francesco and Pratley, Richard and Shih, Weichung J. and Frederich, Robert and Maldonado, Mario and Liu, Jie and Wang, Shuai and Cannon, Christopher P. and on behalf of the VERTIS CV Investigators and Ukraine: and Koval, Olena and Khomazyuk, Tetyana and Panina, Svitlana (2021) Kidney outcomes using a sustained ≥40% decline in eGFR: A meta-analysis of SGLT2 inhibitor trials. Clinical Cardiology, 44 (8). pp. 1139-1143. ISSN 1932-8737 (Online)

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Abstract

Background: A recent meta-analysis of sodium–glucose cotransporter 2 (SGLT2) inhibitor outcome trials reported that SGLT2 inhibitors were associated with reduction in the risk of adverse composite kidney outcomes, with moderate heterogeneity across the trials; however, the endpoints were defined differently across the trials. Hypothesis: The apparent heterogeneity of the meta-analysis of kidney composite outcomes of SGLT2 inhibitor trials will be substantially reduced by using a consistent assessment of sustained ≥40% decline in eGFR/chronic kidney dialysis/transplantation/renal death across trials. Methods: We performed a meta-analysis of kidney composite outcomes from the four SGLT2 cardiovascular outcome trial programs conducted in general type 2 diabetes mellitus populations, which included, as a surrogate of progression to kidney failure, a sustained ≥40% decline in eGFR along with kidney replacement therapy and kidney death. The trials assessed were VERTIS CV (NCT01986881), CANVAS Program (NCT01032629 and NCT01989754), DECLARE-TIMI 58 (NCT01730534), and EMPA-REG OUTCOME (NCT01131676). Results: Data from the trials comprised 42 516 individual participants; overall, 998 composite kidney events occurred. SGLT2 inhibition was associated with a significant reduction in the kidney composite endpoint (HR 0.58 [95% CI 0.51–0.65]) and with a highly consistent effect across the trials (Q statistic p = .64; I 2 = 0.0%). Conclusions: Our meta-analysis highlights the value of using similarly defined endpoints across trials and supports the finding of consistent protection against kidney disease progression with SGLT2 inhibitors as a class in patients with type 2 diabetes mellitus who either have established atherosclerotic cardiovascular disease or are at high cardiovascular risk with multiple cardiovascular risk factors.

Item Type:	Article
Additional Information:	How to cite this article: Cherney DZI, Dagogo-Jack S, McGuire DK, et al. Kidney outcomes using a sustained ≥40% decline in eGFR: A meta-analysis of SGLT2 inhibitor trials. Clin Cardiol. 2021;44(8):1139–1143. https://doi.org/10.1002/clc. 23665
Uncontrolled Keywords:	kidney disease, kidney failure, meta-analysis, randomized clinical trials, SGLT2 inhibitor, type 2 diabetes mellitus
Subjects:	Nephrology Endocrinology
Divisions:	Departments > Department of Internal Medicine 3 (formerly - hospital therapy 2)
Depositing User:	Елена Шрамко
Date Deposited:	02 May 2023 13:00
Last Modified:	04 May 2023 13:25
URI:	http://repo.dma.dp.ua/id/eprint/8351

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