Sodium-glucose co-transporter 2 inhibitors in severe estimated glomerular filtration rate deterioration across cardiovascular-kidney- metabolic conditions: A pooled analysis of randomized trials
Abstract
AIMS: The efficacy of sodium-glucose co-transporter 2 inhibitors (SGLT2i) among patients with cardiovascular-kidney-metabolic (CKM) conditions who experience severe estimated glomerular filtration rate (eGFR) deterioration during follow-up is not well established. The aim of this study was to assess the risk of cardiovascular outcomes and mortality after eGFR deterioration to <25 ml/min/1.73 m2 (and <20 ml/min/1.73 m2), and whether such eGFR deterioration modified the effect of SGLT2i across CKM populations.
METHODS AND RESULTS: Pooled analysis of placebo-controlled trials: EMPEROR-Preserved, EMPEROR-Reduced, EMPA-REG OUTCOME, CANVAS-R, and CREDENCE. Time-updated models with stratification by study were used. The median follow-up to eGFR deterioration was 17 months and total follow-time was 29 months. Studied outcomes included heart failure hospitalization or cardiovascular mortality, the composite of cardiovascular mortality, stroke or myocardial infarction, and all-cause mortality. Overall, 26 946 patients were included, of these 1392 (5.2%) experienced eGFR deterioration to 0.1 for all outcomes). Patients who experienced eGFR deterioration were more likely to permanently discontinue treatment, without significant differences in treatment discontinuation rates between the SGLT2i and placebo groups.
CONCLUSIONS: Severe eGFR deterioration during follow-up was associated with an increased risk of subsequent cardiovascular events and mortality. SGLT2i reduced the probability…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 26 participants or records.
Read the paper
Related studies
- Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa
- Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis
- A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study
- Post‑COVID‑19 Syndrome in Outpatients: a Cohort Study
- Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients
- Electroacupuncture for Painful Diabetic Peripheral Neuropathy: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.