2019
DOI: 10.1016/s2213-8587(19)30180-9
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Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE–TIMI 58 randomised trial

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Cited by 564 publications
(558 citation statements)
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“…In the SGLT‐2i population included in the EMPA‐REG OUTCOME, CANVAS and DECLARE trials, characterized by a low renal risk (mean eGFR, 60‐90 mL/min/1.73 m 2 ; median UACR, ˂30 mg/mmol), the major renal benefits are obtained in T2D diabetic patients with still preserved renal function at baseline. This finding is supported by a recent analysis of renal outcomes in the large subgroup of the DECLARE population with normal or only mildly impaired eGFR, and with normal albuminuria (70% of patients), showing that dapagliflozin reduced by almost 50% the risk of ESKD and eGFR decline in these patients and, thus, suggesting a major role of SGLT‐2i in the early prevention of DKD. On the other hand, the CREDENCE trial demonstrated that, in DKD patients (eGFR, 30 to <90 mL/min/1.73 m 2 and UACR, >33.9 to 565 mg/mmol), the relative risk of the primary renal outcome (ESKD, a doubling of serum creatinine level, or death from renal or cardiovascular causes) is 30% lower in the canagliflozin group than in the placebo group.…”
Section: Cardiorenal Outcomes From Cardiovascular Outcome Trialssupporting
confidence: 54%
“…In the SGLT‐2i population included in the EMPA‐REG OUTCOME, CANVAS and DECLARE trials, characterized by a low renal risk (mean eGFR, 60‐90 mL/min/1.73 m 2 ; median UACR, ˂30 mg/mmol), the major renal benefits are obtained in T2D diabetic patients with still preserved renal function at baseline. This finding is supported by a recent analysis of renal outcomes in the large subgroup of the DECLARE population with normal or only mildly impaired eGFR, and with normal albuminuria (70% of patients), showing that dapagliflozin reduced by almost 50% the risk of ESKD and eGFR decline in these patients and, thus, suggesting a major role of SGLT‐2i in the early prevention of DKD. On the other hand, the CREDENCE trial demonstrated that, in DKD patients (eGFR, 30 to <90 mL/min/1.73 m 2 and UACR, >33.9 to 565 mg/mmol), the relative risk of the primary renal outcome (ESKD, a doubling of serum creatinine level, or death from renal or cardiovascular causes) is 30% lower in the canagliflozin group than in the placebo group.…”
Section: Cardiorenal Outcomes From Cardiovascular Outcome Trialssupporting
confidence: 54%
“…Canagliflozin significantly reduced the risk of the primary composite efficacy outcome for the composite of ESRD, doubling of serum creatinine or death from renal or CV causes by 30% ( P = .00001) . In the DECLARE–TIMI 58 trial, dapagliflozin was associated with a 24% reduction in the risk of the composite of at least a 40% decrease in eGFR to less than 60 mL/min/1.73 m, ESRD or death from renal or CV causes, with a 47% reduction in the risk of the composite of at least a 40% decrease in eGFR to less than 60 mL/min/1.73 m, ESRD or death from renal causes, with a 46% reduction in the risk of a sustained decrease in eGFR of at least 40% to less than 60 mL/min/1.73 m, and with a 59% reduction in the risk of ESRD or death from renal causes compared with placebo . The renoprotective benefits of dapagliflozin were observed among patients with a relatively high level of renal function at baseline (mean eGFR, 85 mL/min/1.73 m), indicating a potential role for dapagliflozin in the early prevention of CKD in patients with T2D .…”
Section: Renal Outcomes With Sglt‐2 Inhibitorsmentioning
confidence: 99%
“…Dapagliflozin was associated with a significant reduction in the risk of the composite end point of CV death or hospitalization for heart failure (HF) in patients with T2D and established CVD or CV risk, while significant reductions in the risk of the composite end point of CV death, nonfatal myocardial infarction (MI) or nonfatal stroke were observed with empagliflozin in patients with T2D and established CVD, and with canagliflozin in patients with T2D and established CVD or multiple CV risk factors . Empagliflozin, canagliflozin and dapagliflozin were also associated with a reduction in the risk of hospitalization for HF, as well as a reduction in the risk of kidney disease progression . The American Diabetes Association (ADA) 2019 Standards of Medical Care in Diabetes, the ADA and European Association for the Study of Diabetes 2018 consensus report and the American Association of Clinical Endocrinologists/American College of Endocrinology 2019 consensus report have taken into consideration the CV and renal complications of T2D when providing a revised treatment strategy for T2D, recommending SGLT‐2i therapy with proven CV or renal benefit in patients with established CVD or chronic kidney disease (CKD) with or without CVD .…”
Section: Introductionmentioning
confidence: 99%
“…In addition, Dr Ofri Mosenzon (Hadassah Hebrew University Hospital, Jerusalem, Israel) presented cardiorenal outcome results from the Dapagliflozin Effect on Cardiovascular Events (DECLARE) trial (N = 17 160) for SGLT‐2 inhibitor dapagliflozin (10 mg) . In comparison to placebo, dapagliflozin conferred (a) greater improvements in urine albumin‐to‐creatinine ratio (UACR) and (b) lower rates of UACR deterioration vs placebo.…”
Section: American Diabetes Association 79th Scientific Session Diabetmentioning
confidence: 99%