Dapagliflozin improves anaemia in patients with CKD with or without T2D

Dapagliflozin significantly increases haematocrit, lowers the incidence of anaemia in non-anaemic patients at baseline, and corrects anaemia in those with anaemia at baseline. The protective and supportive effects of dapagliflozin on haematocrit levels may support its use as a treatment for anaemia in patients with chronic kidney disease (CKD), irrespective of type 2 diabetes (T2D) whilst reducing cardiovascular risk at the same time [1].                                         

“Anaemia is a common complication of CKD which is associated with worse outcomes,” said Prof. Hiddo Heerspink (University of Groningen, Netherlands). In a pre-specified analysis of the DAPA-CKD trial (NCT03036150), the effect of dapagliflozin in preventing and correcting anaemia in patients with CKD with or without T2D was assessed.

The DAPA-CKD study was an international, multi-centre, randomised, double-blind, phase 3 trial which included 4,304 patients. It aimed to evaluate the efficacy of dapagliflozin 10 mg, compared with placebo, in patients with CKD stage 2–4 and elevated urinary albumin excretion, with and without T2D. Anaemia was defined as haematocrit levels <39% in males or <36% in females. “Of patients with haematocrit levels at baseline (99.7%), 36.1% had anaemia. Median follow-up was 2.4 years. We observed that dapagliflozin increased absolute haematocrit levels compared to placebo by 2.3% (95% CI 2.1–2.5; P<0.001). In patients without anaemia at baseline, 9.7% developed anaemia with dapagliflozin compared to 17.0% of patients with placebo (HR 0.53; 95% CI 0.43–0.66; P<0.001),” Prof. Heerspink said. Moreover, dapagliflozin also reduced the risk of developing anaemia-related adverse events compared to placebo (HR 0.46; 95% CI 0.23–0.95; P=0.04). In patients with anaemia at baseline, anaemia was corrected in 47.5% of patients receiving dapagliflozin and in 24.8% of patients receiving placebo (HR 2.27; 95% CI 1.90–2.71; P<0.001). Prof. Heerspink concluded by saying that the effects of dapagliflozin on haematocrit may support its role in the prevention and treatment of anaemia in patients with CKD with or without T2D.

1. Heerspink HJ, et al. Effects of Dapagliflozin on Anemia in Patients With CKD With or Without Type 2 Diabetes: A Pre-Specified Analysis of the DAPA-CKD Trial. SA-OR36, ASN Kidney Week 2022, 3–6 Nov.

 

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Posted on 8 December, 20228 December, 2022