Efficacy of Dapagliflozin by Baseline Diabetes Medications: A Prespecified Analysis From the DAPA-CKD Study
Diabetes Care. 2023; online ahead of print DOI: 10.2337/dc22-1514
Achieving optimal glucose control can be challenging in patients with T2D and CKD because impaired kidney function hampers the use of several oral or injectable glucose-lowering therapies (GLTs) and increases the likelihood of hypoglycaemia. This prespecified analysis from the DAPA-CKD trial evaluated whether the benefits of dapagliflozin in patients with T2D and CKD varied by background GLT number or class.
The effects of dapagliflozin on the primary endpoint (≥50% eGFR decline, ESKD, and kidney or CV death) were found to be consistent across GLT classes and according to the number of GLTs. Similarly, consistent benefit of dapagliflozin vs placebo was observed on the secondary outcomes endpoints, rate of decline of eGFR and safety regardless of background GLT. In addition, dapagliflozin reduced the initiation of insulin therapy during follow-up compared with placebo. These data support the use of dapagliflozin in patients with CKD and T2D in combination with other GLTs.