Initial eGFR Decline with Empagliflozin Has No Impact on Reduction in CV Death


Silvio Inzucchi, MD, discusses an EMPA-REG OUTCOME analysis assessing the impact of empagliflozin in patients who experience an initial dip in eGFR.

New data from an analysis of the EMPA-REG OUTCOME trial indicates the benefits of empagliflozin on cardiovascular death were present regardless if patients experience an initial dip in estimated glomerular filtration rate (eGFR).

Results of the post-hoc analysis suggest the initial, reversible decline in EGFR had no impact on the cardiovascular benefits of empagliflozin and also provides clinicians an overview of potential predictors of the eGFR decline.

Presented at the American Diabetes Association’s (ADA) 80th Scientific Sessions, the analysis was designed to assess whether a 10% or greater decline in eGFR mitigated the impact of empagliflozin on cardiovascular disease and the overall progression of kidney disease. Overall, 28.3% of patients receiving empagliflozin and 13.4% of patients receiving placebo in the EMPA-REG OUTCOME trial experienced a decline of 10% or more in eGFR during the trial.

Investigators highlighted the rates of eGFR decline 30% or greater were uncommon, occurring in 1.4% of patients receiving empagliflozin and 0.9% of patients receiving placebo.

Results of the analysis indicated patients with more advanced kidney disease and those on a diuretic therapy were more likely to experience an eGFR decline of 10% or greater with empagliflozin versus placebo. Additionally, analyses suggested empagliflozin was associated with a reduction in cardiovascular death and renal outcomes regardless of initial decline in eGFR.

For more background on this post-hoc analysis of EMPA-REG OUTCOME, HCPLive® reached out to study presenter Silvio Inzucchi, MD, clinical chief of the Section of Endocrinology and medical director of the Yale Diabetes Center, to take part in a special edition ADA 2020 House Call.

This study, “Implications of Initial EGFR Response to Empagliflozin Treatment Effects,” was presented at ADA 2020.

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