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EMPA-KIDNEY trial shows benefits of empagliflozin in CKD

Reduced risk of renal progression and cardiovascular death in a wide range of people with CKD, with eGFR as low as 20.

Results from the EMPA-KIDNEY trial, published in the New England Journal of Medicine, demonstrate that the SGLT2 inhibitor empagliflozin reduces the risk of renal disease progression or cardiovascular death in a wide range of people with chronic kidney disease (CKD), with eGFR as low as 20 mL/min/1.73 m2.

A total of 6609 people with CKD and either an eGFR of 20–45 or an eGFR of 45­–90 plus an urinary albumin:creatinine ratio (ACR) of ≥200 mg/g (≥26.6 mg/mmol) were randomised to empagliflozin or placebo. The trial was ended early due to prespecified efficacy endpoints being met. Over a median of 2 years’ follow-up, the primary endpoint, a composite of renal disease progression or death from cardiovascular causes, occurred in 13.1% of empagliflozin recipients versus 16.9% of placebo recipients (hazard ratio 0.72; 95% CI 0.64–0.82). The rate of all-cause hospitalisation was lower in the empagliflozin group (hazard ratio, 0.86; 95% CI 0.78–0.95).

There were no significant differences in rates of all-cause mortality or the composite outcome of hospitalisation for heart failure or cardiovascular death; however, this may have been due to the low number of events owing to the early discontinuation of the trial.

Results were consistent irrespective of type 2 diabetes status and across subgroups defined according to eGFR ranges. The rates of serious adverse events were similar in the empagliflozin and placebo groups.

Click here to read the study results in full.

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