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Editorial

SGLT-2 inhibitors: A new era in managing diabetic kidney disease starts now

Jonathan J. Taliercio, DO, George Thomas, MD, Georges N. Nakhoul, MD, MEd, Tushar J. Vachharajani, MD and Ali Mehdi, MD, MEd
Cleveland Clinic Journal of Medicine January 2021, 88 (1) 59-63; DOI: https://doi.org/10.3949/ccjm.88a.20190
Jonathan J. Taliercio
Program Director, Nephrology and Hypertension Fellowship, Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic; Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Co-investigator, EMPA-KIDNEY study
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  • For correspondence: [email protected]
George Thomas
Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic; Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Principal Investigator, EMPA-KIDNEY study
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Georges N. Nakhoul
Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic; Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Co-investigator, EMPA-KIDNEY study
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Tushar J. Vachharajani
Department of Hypertension and Nephrology, Glickman Urological and Kidney Institute, Cleveland Clinic; Clinical Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Principal Investigator, EMPA-KIDNEY study
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Ali Mehdi
Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic; Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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    TABLE 1

    Renal outcomes of the major trials of sodium-glucose cotransporter 2 inhibitors

    TrialAgentComposite kidney outcomePrimary or secondary end pointsHazard ratio (95% CI)Number needed to treat
    EMPA-REG OUTCOME8EmpagliflozinDoubling of the serum creatinine level, initiation of kidney replacement therapy, or death from renal diseaseSecondary0.54 (0.40–0.75)194
    CANVAS10CanagliflozinSustained 40% reduction in eGFR, need for kidney replacement therapy, or death from renal causesSecondary0.60 (0.47–0.77)286
    DECLARE-TIMI 5811DapagliflozinSustained ≥ 40% reduction in eGFR to < 60 mL/min/1.73 m2, new end-stage kidney disease, or death from renal causeSecondary0.53 (0.43–0.66)78
    EMPEROR-Reduced9EmpagliflozinSustained ≥ 40% reduction in eGFR, chronic dialysis, renal transplant, or sustained eGFR < 10–15 mL/min/1.73 m2Secondary0.50 (0.32–0.77)68
    CREDENCE12CanagliflozinEnd-stage kidney disease, doubling of the serum creatinine level, or death from renal or cardiovascular causesPrimary0.70 (0.59–0.82)22
    DAPA-CKD13DapagliflozinSustained ≥ 50% reduction in eGFR, end-stage kidney disease, or death from renal or cardiovascular causePrimary0.61 (0.51–0.72)19
    EMPA-KIDNEY14EmpagliflozinEnd-stage kidney disease, a sustained reduction in eGFR to < 10 mL/min/1.73 m2, renal death, or a sustained decline of ≥ 40% in eGFRPrimaryOngoingOngoing
    • CANVAS = Canagliflozin Cardiovascular Assessment Study; CI = confidence interval; CREDENCE = Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation; DAPA-CKD = Dapagliflozin in Patients With Chronic Kidney Disease; DECLARE-TIMI 58 = Dapagliflozin Effect on Cardiovascular Events; eGFR = estimated glomerular filtration rate; EMPA-KIDNEY = Study of Heart and Kidney Protection With Empagliflozin; EMPA-REG OUTCOME = Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients; EMPEROR-Reduced = Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction

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Cleveland Clinic Journal of Medicine: 88 (1)
Cleveland Clinic Journal of Medicine
Vol. 88, Issue 1
1 Jan 2021
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SGLT-2 inhibitors: A new era in managing diabetic kidney disease starts now
Jonathan J. Taliercio, George Thomas, Georges N. Nakhoul, Tushar J. Vachharajani, Ali Mehdi
Cleveland Clinic Journal of Medicine Jan 2021, 88 (1) 59-63; DOI: 10.3949/ccjm.88a.20190

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SGLT-2 inhibitors: A new era in managing diabetic kidney disease starts now
Jonathan J. Taliercio, George Thomas, Georges N. Nakhoul, Tushar J. Vachharajani, Ali Mehdi
Cleveland Clinic Journal of Medicine Jan 2021, 88 (1) 59-63; DOI: 10.3949/ccjm.88a.20190
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  • Article
    • THE WRITING WAS ON THE WALL
    • INSIGHTS FROM DAPA-CKD
    • MOVING THE GOAL POST: THE 2020 KDIGO GUIDELINE
    • KEY TAKEAWAYS AND PRACTICE POINTERS
    • FUTURE DIRECTIONS
    • A NEW ERA IN THE TREATMENT OF DIABETIC KIDNEY DISEASE
    • DISCLOSURES
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