Effects of ipragliflozin on the development and progression of kidney disease in patients with type 2 diabetes: An analysis from a multicenter prospective intervention study

• Main Authors: Ikuro Matsuba, Takehiro Kawata, Kotaro Iemitsu, Taro Asakura, Hikaru Amemiya, Masashi Ishikawa, Syogo Ito, Mizuki Kaneshiro, Akira Kanamori, Akira Kubota, Kazuaki Shinoda, Masahiko Takai, Tetsuo Takuma, Masahiro Takihata, Hiroshi Takeda, Keiji Tanaka, Yoko Matsuzawa, Hideo Machimura, Fuyuki Minagawa, Nobuaki Minami, Atsuko Mokubo, Masaaki Miyakawa, Yasuo Terauchi, Yasushi Tanaka
• Format: Article
• Language: English
• Published: Wiley 2020-09-01
• Series: Journal of Diabetes Investigation
• Subjects: Diabetic nephropathy; Ipragliflozin; Sodium–glucose cotransporter 2 inhibitor
• Online Access: https://doi.org/10.1111/jdi.13248
• ISSN: 2040-1116; 2040-1124

Abstract Aims/Introduction Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long‐term treatments are available. Methods This was an investigator‐initiated multicenter prospective intervention study in which ipragliflozin (50 mg) was administered once daily, and glycemic control, estimated glomerular filtration rate (eGFR) and adverse events were evaluated until 104 weeks after starting research. Results There were 407 patients analyzed. In the eGFR ≥90 group and eGFR ≥60 to <90 group, eGFR had significantly decreased compared with baseline at all time points from 4 to 104 weeks. There were significant increases in the eGFR ≥45 to <60 groups compared with baseline at 36 weeks (2.3 ± 1.0) and 52 weeks (2.6 ± 1.2). Comparison between the eGFR <60, urine albumin‐to‐creatinine ratio >300 group and the eGFR <60, urine albumin‐to‐creatinine ratio <300 group showed a greater reduction in eGFR in the former (−5.4 ± 2.4 vs 3.3 ± 1.1) at 12 weeks and was maintained to 104 weeks. In any group, eGFR did not significantly decrease until 104 weeks compared with 4 weeks. The urine albumin‐to‐creatinine ratio after 52 weeks and after 104 weeks was significantly decreased compared with baseline in the eGFR ≥90 group. Conclusions Ipragliflozin lowers eGFR and corrects hyperfiltration in patients with high eGFR (eGFR ≥60). In patients with low eGFR (eGFR ≥30 to <60), ipragliflozin has the possibility of increasing eGFR and exerting a renoprotective effect.