Empagliflozin Reduces Risk for Nephropathy Regardless of Blood Pressure, LDL Cholesterol, HbA1c
Investigators defined control of parameters by systolic BP <140 mm Hg, diastolic BP <90 mm Hg, LDL-C <100, and HbA1c <7.5%.
|The following article is part of conference coverage from the American Diabetes Association's 78th Scientific Sessions (ADA 2018) in Orlando,Florida. Endocrinology Advisor's staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back for the latest news from ADA 2018.|
ORLANDO – In patients with type 2 diabetes (T2D) and cardiovascular disease, empagliflozin reduces the risk for incident or worsening nephropathy regardless of whether blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), or hemoglobin (Hb)A1c are controlled, according to results presented at the American Diabetes Association's 78th Scientific Sessions held in Orlando, Florida, June 22-26, 2018.
The study included participants with T2D and established cardiovascular disease (n=6185). Participants were randomly assigned to empagliflozin 10 mg, empagliflozin 25 mg, or placebo. The researchers assessed the risk for incident or worsening nephropathy, controlling for BP, LDL-C, and HbA1c. They defined control of systolic BP as <140 mm Hg, diastolic BP as <90 mm Hg, LDL-C as <100 mg/dL, and HbA1c as <7.5%.
When the researchers adjusted for control of BP, the hazard ratio (HR) for time to incident or worsening nephropathy with empagliflozin vs placebo was 0.67 (95% CI, 0.59-0.76). When they adjusted for control of LDL-C, the HR was 0.61 (95% CI, 0.53-0.69), and when they adjusted for control of HbA1c, it was 0.65 (95% CI, 0.57-0.74).
After adjusting for control of all 3 parameters, the researchers found an HR of 0.65 (95% CI, 0.57-0.75) for time to incident or worsening nephropathy with empagliflozin vs placebo.
Together, these results suggest that empagliflozin provides risk reductions for renal outcomes regardless of whether or not conventional cardiovascular risk factors are controlled for.
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Wanner C, Cooper ME, Inzucchi S, et al. Empagliflozin improves renal outcomes irrespective of control of blood pressure, low-density lipoprotein cholesterol, and HbA1c. Presented at: ADA 2018 78th Scientific Sessions; June 22-26, 2018; Orlando, FL. Poster 524.