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Do Renal Benefits of Empagliflozin Vary By Glycemic Control Level?

In type 2 diabetes, empagliflozin (EMPA) likely has beneficial renal effects regardless of patients’ level of glycemic control prior to and during therapy, according to new findings.
Researchers arrived at this conclusion following an analysis of the EMPA-REG OUTCOME Trial. During the trial, 7020 patients were randomly assigned 1:1:1 to 10 mg EMPA, 25 mg EMPA, or placebo. Median time of observation lasted 3.1 years. For the first 12 weeks of the trial, background glucose-lowering treatments remain unchanged.
Renal outcomes were assessed in the pooled group of EMPA-treated vs placebo-treated patients, following adjustment for baseline hemoglobin A1c (HBA1c), for HbA1c control during the trial as a time-dependent factor, and by HbA1c reduction from baseline to week 12.
Ultimately, the results of the study indicated that the decrease in the risks of incident or worsening nephropathy in EMPA-treated vs placebo-treated patients was consistent regardless of baseline HbA1c or subsequent changes in glycemic control during active therapy.
“EMPA-KIDNEY, the outcome study of heart and kidney protection with EMPA, will provide additional insights into potential glycemia-independent kidney effects of EMPA in patients with and without diabetes,” the researchers concluded.

REFERENCE:
Cooper ME, Inzucchi SE, Zinman B, et al. Does glucose control influence the effect of empagliflozin on kidney outcomes in type 2 diabetes (T2D)? Insights from the EMPA-REG OUTCOME Trial. Paper presented at: American Society of Nephrology Kidney Week 2018; October 23-28, 2018; San Diego, CA.

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