Dapagliflozin reduces number of hospitalisations in patients with CKD

Treatment with dapagliflozin reduces the rate of all-cause hospital admissions among patients with chronic kidney disease (CKD) irrespective of the presence of 2 diabetes (T2D) in comparison with placebo. The number needed to treat to prevent 1 hospitalisation during the study was 23
(95% CI 14–63) [1].

Patients with CKD have a high risk of emergency hospitalisation, which is associated with poor outcomes, according to Dr Meir Schechter (Universitair Medisch Centrum Groningen, Netherlands). A post hoc analysis of the DAPA-CKD study (NCT03036150) assessed the effect of dapagliflozin on all-cause and cause-specific hospitalisation in patients with CKD. The DAPA-CKD study was an international, multi-centre, randomised, double-blind, phase 3 trial in 4,304 patients. The study was designed 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. Primary composite endpoint was worsening of renal function or risk of death (defined as a composite of an eGFR decline ≥50%, onset of kidney failure, or death from cardiovascular or renal cause). Secondary endpoints included time to first occurrence of the renal composite (sustained ≥50% eGFR decline, kidney or renal death), the composite of CV death or hospitalisation for heart failure, and death from any cause. “28.4% of patients in the study were hospitalised, which translated to 26.3% of patients in the dapagliflozin arm and 30.6% of patients in the placebo arm,” said Dr Schechter. “There was no evidence that the effects of dapagliflozin on hospitalisations varied by baseline diabetes status, eGFR, or UACR” (see Figure).

Figure: Outcomes according to baseline status

eGFR, estimated glomerular filtration rate; UACR, urinary albumin-to-creatinine ratio.

“The findings from this study may have significant implications for the quality of life of the individual patient as well as on total healthcare burden and expenditure attributed to CKD,” Dr Schechter pointed out.

1. Schechter M, et al. Dapagliflozin Effect on Hospital Admissions in Patients With CKD: A Post Hoc Analysis of the DAPA-CKD Trial. FR-OR26, ASN Kidney Week 2022, 3–6 Nov.

 

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Posted on 8 December, 2022