Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial
Abstract Aims/Introduction In the EMPA‐REG OUTCOME® trial, empagliflozin added to standard of care improved clinically relevant kidney outcomes by 39%, slowed progression of chronic kidney disease, and reduced albuminuria in patients with type 2 diabetes and established cardiovascular disease. This...
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doaj-37e2f4567a3542ca93e105b53c11a2272021-05-02T16:07:20ZengWileyJournal of Diabetes Investigation2040-11162040-11242019-05-0110376077010.1111/jdi.12971Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trialTakashi Kadowaki0Masaomi Nangaku1Stefan Hantel2Tomoo Okamura3Maximilian vonEynatten4Christoph Wanner5Audrey Koitka‐Weber6Graduate School of Medicine The University of Tokyo Tokyo JapanGraduate School of Medicine The University of Tokyo Tokyo JapanBoehringer Ingelheim International GmbH Biberach GermanyNippon Boehringer Ingelheim Co., Ltd Tokyo JapanBoehringer Ingelheim International GmbH IngelheimGermanyDepartment of Medicine Würzburg University Clinic Würzburg GermanyBoehringer Ingelheim International GmbH IngelheimGermanyAbstract Aims/Introduction In the EMPA‐REG OUTCOME® trial, empagliflozin added to standard of care improved clinically relevant kidney outcomes by 39%, slowed progression of chronic kidney disease, and reduced albuminuria in patients with type 2 diabetes and established cardiovascular disease. This exploratory analysis investigated the effects of empagliflozin on the kidneys in Asian patients. Materials and Methods Participants in the EMPA‐REG OUTCOME® trial were randomized (1:1:1) to empagliflozin 10 mg, 25 mg or a placebo. In patients of Asian race, we analyzed incident or worsening nephropathy (progression to macroalbuminuria, doubling of serum creatinine, initiation of renal‐replacement therapy or renal death) and its components, estimated glomerular filtration rate (eGFR) and urine albumin‐to‐creatinine ratio changes, and renal safety. Results Of 7,020 treated patients, 1,517 (26.1%) were Asian. In this subgroup, consistent with the overall trial population, empagliflozin reduced the risk of incident or worsening nephropathy (hazard ratio 0.64, 95% confidence interval 0.49–0.83), progression to macroalbuminuria (hazard ratio 0.64, 95% confidence interval 0.49–0.85) and the composite of doubling of serum creatinine, initiation of renal‐replacement therapy or renal death (hazard ratio 0.48, 95% confidence interval 0.25–0.92). Furthermore, empagliflozin‐treated participants showed slower eGFR decline versus placebo, and showed rapid urine albumin‐to‐creatinine ratio reduction at week 12, maintained through week 164, with effects most pronounced in those with baseline microalbuminuria or macroalbuminuria. The kidney safety profile of empagliflozin in the Asian subgroup was similar to the overall trial population. Conclusions In Asian patients from the EMPA‐REG OUTCOME® trial, empagliflozin improved kidney outcomes, slowed eGFR decline and lowered albuminuria versus placebo, consistent with the overall trial population findings.https://doi.org/10.1111/jdi.12971Diabetic kidney diseaseEmpagliflozinType 2 diabetes mellitus |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takashi Kadowaki Masaomi Nangaku Stefan Hantel Tomoo Okamura Maximilian vonEynatten Christoph Wanner Audrey Koitka‐Weber |
spellingShingle |
Takashi Kadowaki Masaomi Nangaku Stefan Hantel Tomoo Okamura Maximilian vonEynatten Christoph Wanner Audrey Koitka‐Weber Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial Journal of Diabetes Investigation Diabetic kidney disease Empagliflozin Type 2 diabetes mellitus |
author_facet |
Takashi Kadowaki Masaomi Nangaku Stefan Hantel Tomoo Okamura Maximilian vonEynatten Christoph Wanner Audrey Koitka‐Weber |
author_sort |
Takashi Kadowaki |
title |
Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial |
title_short |
Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial |
title_full |
Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial |
title_fullStr |
Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial |
title_full_unstemmed |
Empagliflozin and kidney outcomes in Asian patients with type 2 diabetes and established cardiovascular disease: Results from the EMPA‐REG OUTCOME® trial |
title_sort |
empagliflozin and kidney outcomes in asian patients with type 2 diabetes and established cardiovascular disease: results from the empa‐reg outcome® trial |
publisher |
Wiley |
series |
Journal of Diabetes Investigation |
issn |
2040-1116 2040-1124 |
publishDate |
2019-05-01 |
description |
Abstract Aims/Introduction In the EMPA‐REG OUTCOME® trial, empagliflozin added to standard of care improved clinically relevant kidney outcomes by 39%, slowed progression of chronic kidney disease, and reduced albuminuria in patients with type 2 diabetes and established cardiovascular disease. This exploratory analysis investigated the effects of empagliflozin on the kidneys in Asian patients. Materials and Methods Participants in the EMPA‐REG OUTCOME® trial were randomized (1:1:1) to empagliflozin 10 mg, 25 mg or a placebo. In patients of Asian race, we analyzed incident or worsening nephropathy (progression to macroalbuminuria, doubling of serum creatinine, initiation of renal‐replacement therapy or renal death) and its components, estimated glomerular filtration rate (eGFR) and urine albumin‐to‐creatinine ratio changes, and renal safety. Results Of 7,020 treated patients, 1,517 (26.1%) were Asian. In this subgroup, consistent with the overall trial population, empagliflozin reduced the risk of incident or worsening nephropathy (hazard ratio 0.64, 95% confidence interval 0.49–0.83), progression to macroalbuminuria (hazard ratio 0.64, 95% confidence interval 0.49–0.85) and the composite of doubling of serum creatinine, initiation of renal‐replacement therapy or renal death (hazard ratio 0.48, 95% confidence interval 0.25–0.92). Furthermore, empagliflozin‐treated participants showed slower eGFR decline versus placebo, and showed rapid urine albumin‐to‐creatinine ratio reduction at week 12, maintained through week 164, with effects most pronounced in those with baseline microalbuminuria or macroalbuminuria. The kidney safety profile of empagliflozin in the Asian subgroup was similar to the overall trial population. Conclusions In Asian patients from the EMPA‐REG OUTCOME® trial, empagliflozin improved kidney outcomes, slowed eGFR decline and lowered albuminuria versus placebo, consistent with the overall trial population findings. |
topic |
Diabetic kidney disease Empagliflozin Type 2 diabetes mellitus |
url |
https://doi.org/10.1111/jdi.12971 |
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