Physicians' Academy for Cardiovascular Education
Acute reversible decline in eGFR seen with SGTL2 inhibitor in T2DM patients with or without HF

Acute reversible decline in eGFR seen with SGTL2 inhibitor in T2DM patients with or without HF

News - Apr. 30, 2017

Paris, France | Empagliflozin decreases risk of kidney function decline in type 2 diabetes: slope analyses in patients with and without heart failure at baseline from the EMPA-REG OUTCOME trial

Presented at ESC Heart Failure 2017 by Alfred CHUENG (Salt Lake City, UT, USA)

Main results

Conclusion

These analyses show that eGFR slope analyses represent a useful method to investigate the effect of SGLT2 inhibitors on kidney function. Furthermore, it showed that the SGLT2 inhibitor empagliflozin caused an acute decline in eGFR (on a high background of ACEi/ARB use), which is apparently reversible upon stopping treatment. Empagliflozin appeared to prevent a decline in eGFR seen in patients receiving placebo. This pattern of eGFR changes was similar in patients with and without pre-existing HF.

Ongoing trials are further investigating the effects of empagliflozin on kidney function in patients (with or without diabetes) with HFrEF (EMPEROR-reduced) and with HFpEF (EMPEROR-preserved).

During the discussion, dr. Giuseppe M C ROSANO (London, GB) postulated that maybe an initial diuretic effect may explain the observations, as also an initial reduction of body weight was seen. Thus, the effect on eGFR may represent a diuretic effect rather than an effect of the drug itself. Also, he noted that while one would like to keep renal function in good shape, the drug lowers mortality and morbidity, which is outweighs the effects on renal function.

Disclosures

Our coverage of ESC HF 2017 is based on the information provided during the congress.

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