- Dapagliflozin±saxagliptin added to an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) slows progression of moderate-severe chronic kidney disease (CKD) in patients with type 2 diabetes (T2D).
Why this matters
- In patients with established T2D and CKD, optimized glycemic control and currently available albuminuria-lowering treatments are insufficient to prevent progressive kidney function loss.
- Double-blind, placebo-controlled, multicenter trial.
- Included patients with T2D; urine albumin to creatinine ratio (UACR), 30-3500 mg/g; estimated glomerular filtration rate, 25-75 mL/min/1.73 m2; and HbA1c, 7.0%-11.0% (53-97 mmol/mol) receiving ACEI or ARBs and glucose-lowering medications.
- Participants were randomly allocated to placebo (n=148), 10 mg dapagliflozin (Farxiga; n=145), or dapagliflozin+2.5 mg saxagliptin (Onglyza; n=155) for 24 weeks.
- Funding: AstraZeneca.
- In dapagliflozin group at week 4, difference in mean change from baseline UACR was −28.3% (P<.0001 vs placebo sustained through week difference p=".011).</li">
- In dapagliflozin+saxagliptin group, those values were −34.5% (P<.0001 and respectively.>
- Proportions achieving HbA1c
- 10.3% placebo;
- 15.0% dapagliflozin: OR vs placebo, 1.7 (P=.17); and
- 35.1% dapagliflozin+saxagliptin: OR vs placebo, 5.4 (P<.0001>
- No saxagliptin-alone group.
- Short follow-up.
- Single albuminuria measurement.