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.
Empagliflozin in Black Versus White Patients with Heart Failure: Analysis of EMPEROR-Pooled
Circulation. 2022; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062644
While analyses from DAPA-HF and EMPEROR-Reduced demonstrated a consistent benefit of SGLT2i in Black patients, data were limited to HFrEF and included a small number of Black patients. In the current analysis, the efficacy and safety of empagliflozin according to Black vs White race in the Americas was assessed across the spectrum of EF in EMPEROR-Pooled, a combined dataset from both EMPEROR trials.
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Efficacy and Safety of Dapagliflozin by Baseline Insulin Regimen and Dose: Post Hoc Analyses From DECLARE-TIMI 58
Diabetes Care. 2022; online ahead of print DOI: 10.2337/dc22-1318
Limited data exist regarding the cardiorenal efficacy and safety of SGLT2i in patients treated with intensive insulin regimens including short-acting insulin or high insulin doses. This post hoc analysis of DECLARE-TIMI 58 examined the effects of dapagliflozin vs placebo among 7,013 insulin users at baseline, of whom 4,650 were on regimens that included short-acting insulin and 1,339 were receiving insulin >1 IU/kg.
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Canagliflozin and atrial fibrillation in type 2 diabetes mellitus: A secondary analysis from the CANVAS Program and CREDENCE trial and meta-analysis
Diabetes Obes Metab. 2022;24:1927–1938 DOI: 10.1111/dom.14772
A pooled analysis from the CANVAS Program and CREDENCE trial found that canagliflozin did not have a significant effect on the incidence of atrial fibrillation/atrial flutter (AF/AFL) in patients with type 2 diabetes and high risk of cardiovascular disease or chronic kidney disease.
Association of Empagliflozin Treatment With Albuminuria Levels in Patients With Heart Failure: A Secondary Analysis of EMPEROR-Pooled
JAMA Cardiol. 2022; online ahead of print DOI: 10.1001/jamacardio.2022.2924
In a post-hoc analysis of EMPEROR-Pooled, empagliflozin was associated with a reduction in the primary outcome irrespective of albuminuria levels at baseline compared with placebo, and there was reduced progression to macroalbuminuria and reversion of macroalbuminuria.
Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Sodium–Glucose Cotransporter 2 Inhibitor Treatment: The FIDELITY Analysis
Diabetes Care 2022; online ahead of print doi: 10.2337/dc22-0294
In the FIDELITY analysis, finerenone reduced the risk of cardiovascular and kidney outcomes compared with placebo. Concomitant treatment with a sodium-glucose cotransporter-2 inhibitor (SGLT2i) did not modify the observed benefits.
FIDELITY pooled populations from the FIDELIO-DKD and FIGARO-DKD studies in order to examine the effect of finerenone and interaction with SGLT2i use on prespecified outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). In both trial, use of SGLT2i was permitted at baseline, as was initiation of SGLT2i at any time during the trial.
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.
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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.
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.