July 2022

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.

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Effects of Canagliflozin Versus Finerenone on Cardiorenal Outcomes: Exploratory Post Hoc Analyses From FIDELIO-DKD Compared to Reported CREDENCE Results

Nephrol Dial Transplant 2022;37:1261-9 doi.org/10.1093/ndt/gfab336

This analysis highlights the pitfalls of direct comparisons between trials, since when key differences in design are considered, FIDELIO-DKD and CREDENCE demonstrate similar cardiorenal benefits. The authors conclude that both canagliflozin and finerenone are similarly effective in reducing the risk of cardiorenal outcomes.

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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.

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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).

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Efficacy of Subcutaneous Semaglutide Compared to Placebo For Weight Loss in Obese, Non-diabetic Adults: A Systematic Review & Meta-Analysis

Int J Clin Pharm 2022; online ahead of print DOI: 10.1007/s11096-022-01428-1

This systematic review and meta-analysis validates the clinical efficacy of semaglutide for the treatment of obesity in adults without T2D. There is substantial evidence for clinicians to consider modification to their management obese population.

Research of the effect of semaglutide on weight loss has largely focused on T2D, and no meta-analyses in non-diabetic individuals have been conducted to date.

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May 2022

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.

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The Comparative Cardiovascular and Renal Effectiveness of Sodium-Glucose Co-Transporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists: A Scandinavian Cohort Study

Diabetes Obes Metab 2022;24:473–85 doi: 10.1111/dom.14598

In this study by Ueda et al., SGLT2 inhibitors were associated with a similar risk of heart failure and a lower risk of serious renal events compared with GLP-1 receptor agonist,s and the use of GLP-1 receptor agonists was associated with a slightly lower risk of MACE compared with SGLT2 inhibitors.

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