Publications
Stay up to date with our literature reviews which are curated by experts to feature the most important publications released each month. Explore our publications for access to concise summary slides for your own use.
Obesity and Effects of Dapagliflozin on Cardiovascular and Renal Outcomes in Patients With Type 2 Diabetes Mellitus in the DECLARE-TIMI 58 trial
Eur Heart J 2022;43:2958-67 doi.org/10.1093/eurheartj/ehab530
In the DECLARE-TIMI 58 trial, patients with type 2 diabetes and higher body weight were more likely to have hospitalisation for heart failure (HHF) and atrial fibrillation or flutter (AF/AFL).
Effect of Empagliflozin on Kidney Biochemical and Imaging Outcomes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure with Reduced Ejection Fraction (SUGAR-DM-HF)
Circulation 2022;146:364-7 DOI: 10.1161/CIRCULATIONAHA.122.059851
This study found that a reduction in kidney perfusion and congestion may be mechanisms by which sodium-glucose cotransporter-2 inhibitors (SGLT2i) affect kidney function in people with heart failure with reduced ejection fraction (HFrEF). The authors believe this is the first kidney MRI trial using SGLT2i in this patient group.
Empagliflozin for Heart Failure With Preserved Left Ventricular Ejection Fraction With and Without Diabetes
Circulation 2022; online ahead of print
In patients enrolled in EMPEROR-Preserved, empagliflozin significantly reduced the risk of heart failure (HF) outcomes irrespective of diabetes status.
Keywords:
Design of the COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using an UACR Endpoint study (CONFIDENCE)
Nephrol Dial Transplant 2022 Jun 14;gfac198. Online ahead of print. doi: 10.1093/ndt/gfac198.
CONFIDENCE is a new trial currently recruiting. The aim is to demonstrate that 6 months’ dual therapy with finerenone and empagliflozin is superior for reducing albuminuria versus either agent alone.
Despite available interventions, people with T2D remain at risk of chronic kidney disease, which puts them at further risk of kidney failure, CV morbidity, and all-cause mortality. There is therefore a need to slow or attenuate the progression of chronic kidney disease (CKD) and reduce CV morbidity and mortality in this population.
Finerenone and sodium-glucose cotransporter-2 inhibitors (SGLT2i) can both reduce kidney and CV risks, acting via both shared and distinct pathophysiological pathways. Results from post hoc subgroup analyses and a preclinical model suggest dual therapy may provide additive renoprotective effects than using either class alone.
Empagliflozin and Serum Potassium in Heart Failure: An Analysis From Emperor-Pooled
Eur Heart J 2022; online ahead of print DOI: 10.1093/eurheartj/ehac306
In this pooled analysis, empagliflozin reduced the incidence of hyperkalaemia without significant increase in hypokalaemia.
Potassium is essential for normal cellular function, but severe potassium abnormalities can lead to cardiac arrhythmias and death. Hyperkalaemia frequently leads to interruption and discontinuation of neurohormonal antagonists, which may worsen the prognosis for people with heart failure (HF).
Empagliflozin and Incidence of Events Consistent With Acute Kidney Injury: Pooled Safety Analysis in More Than 15,000 Individuals
Diabetes Obes Metab 2022;24:1390-3 doi: 10.1111/dom.14694
In this pooled analysis of patients from the global empagliflozin trial programme, the risk of acute kidney injury (AKI) and acute kidney disease (AKD) with empagliflozin was comparable with placebo. This comprehensive analysis indicates that empagliflozin is not associated with an increased risk of acute kidney failure compared with placebo treatment.
Effects of canagliflozin on Myocardial Infarction: A Post Hoc Analysis of the CANVAS Programme and CREDENCE Trial
Cardiovasc Res 2022;118:1103–14
Yu et al. report that canagliflozin is not associated with a reduction in overall myocardial infarction in the pooled CANVAS and CREDENCE population. The CANVAS cohort found a possible differential effect on ST-elevation myocardial infarction (STEMI) and non-STEMI warranting further investigation.
Cardiovascular Outcomes with Finerenone According to Glycemic Status at Baseline and Prior Treatment with Newer Antidiabetics among Patients with Type 2 Diabetes Mellitus
Endocrinol Metab 2022;37:170–4; doi.org/10.3803/EnM.2021.1296
Finerenone induced a 13% risk reduction in MACE (a composite of death from CV causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalisation for heart failure) regardless of prior glycaemia. There was no difference in finerenone-derived MACE benefits whether patients were on baseline SGLT2i or GLP-1RA or not.
Effects of Canagliflozin and Metformin on Insulin Resistance and Visceral Adipose Tissue in People With Newly-diagnosed Type 2 Diabetes
BMC Endocrine Disorders 2022;22:37 doi.org/10.1186/s12902-022-00949-0
In this study of patients with newly-diagnosed (<6 months) T2D, canagliflozin was associated with reduced insulin resistance and visceral adipose tissue compared with placebo.
Finerenone in Predominantly Advanced CKD and Type 2 Diabetes With or Without Sodium-Glucose Cotransporter-2 Inhibitor Therapy
Kidney Int Rep 2022;7:36–45 doi.org/10.1016/j.ekir.2021.10.008
Finerenone was associated with a 31% greater reduction in urine albumin:creatinine ratio (UACR) from baseline to Month 4 versus placebo. With similar reductions in UACR seen whether the patient was receiving SGLT2i at baseline or not.