TY - JOUR
T1 - Efficacy and Safety of Dapagliflozin by Baseline Glycemic Status
T2 - A Prespecified Analysis From the DAPA-CKD Trial
AU - for the DAPA-CKD Trial Committees Investigators
AU - Persson, Frederik
AU - Rossing, Peter
AU - Vart, Priya
AU - Chertow, Glenn M.
AU - Hou, Fan Fan
AU - Jongs, Niels
AU - McMurray, John J.V.
AU - Correa-Rotter, Ricardo
AU - Bajaj, Harpreet S.
AU - Stefansson, Bergur V.
AU - Toto, Robert D.
AU - Langkilde, Anna Maria
AU - Wheeler, David C.
AU - Heerspink, Hiddo J.L.
N1 - Funding Information:
G.M.C. has received research grants from the National Institute of Diabetes and Digestive and Kidney Diseases.
Publisher Copyright:
© 2021 by the American Diabetes Association.
PY - 2021/8
Y1 - 2021/8
N2 - OBJECTIVE The Dapagliflozin and Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) study demonstrated risk reduction for kidney and cardiovascular outcomes with dapagliflozin versus placebo in participants with chronic kidney disease (CKD) with and without diabetes. We compared outcomes according to baseline glycemic status. RESEARCH DESIGN AND METHODS We enrolled participants with CKD, estimated glomerular filtration rate (eGFR) 25–75 mL/min/1.73 m2, and urinary albumin-to-creatinine ratio 200–5,000 mg/g. The primary composite end point was sustained eGFR decline $50%, end-stage kidney disease, or kidney or cardiovascular death. RESULTS Of 4,304 participants, 738 had normoglycemia, 660 had prediabetes, and 2,906 had type 2 diabetes. The effect of dapagliflozin on the primary outcome was con-sistent (P for interaction 5 0.19) in normoglycemia (hazard ratio [HR] 0.62 [95% CI 0.39, 1.01]), prediabetes (HR 0.37 [0.21, 0.66]), and type 2 diabetes (HR 0.64 [0.52, 0.79]). We found no evidence for effect modification on any outcome. Adverse events were similar, with no major hypoglycemia or ketoacidosis in participants with normoglycemia or prediabetes. CONCLUSIONS Dapagliflozin safely reduced kidney and cardiovascular events independent of baseline glycemic status.
AB - OBJECTIVE The Dapagliflozin and Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) study demonstrated risk reduction for kidney and cardiovascular outcomes with dapagliflozin versus placebo in participants with chronic kidney disease (CKD) with and without diabetes. We compared outcomes according to baseline glycemic status. RESEARCH DESIGN AND METHODS We enrolled participants with CKD, estimated glomerular filtration rate (eGFR) 25–75 mL/min/1.73 m2, and urinary albumin-to-creatinine ratio 200–5,000 mg/g. The primary composite end point was sustained eGFR decline $50%, end-stage kidney disease, or kidney or cardiovascular death. RESULTS Of 4,304 participants, 738 had normoglycemia, 660 had prediabetes, and 2,906 had type 2 diabetes. The effect of dapagliflozin on the primary outcome was con-sistent (P for interaction 5 0.19) in normoglycemia (hazard ratio [HR] 0.62 [95% CI 0.39, 1.01]), prediabetes (HR 0.37 [0.21, 0.66]), and type 2 diabetes (HR 0.64 [0.52, 0.79]). We found no evidence for effect modification on any outcome. Adverse events were similar, with no major hypoglycemia or ketoacidosis in participants with normoglycemia or prediabetes. CONCLUSIONS Dapagliflozin safely reduced kidney and cardiovascular events independent of baseline glycemic status.
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U2 - 10.2337/DC21-0300
DO - 10.2337/DC21-0300
M3 - Article
C2 - 34183431
AN - SCOPUS:85114206135
SN - 0149-5992
VL - 44
SP - 1894
EP - 1897
JO - Diabetes care
JF - Diabetes care
IS - 8
ER -