Patients with type 2 diabetes (T2DM) suffer from Severe Kidney disease (Diabetic kidney disease) a foremost cause of end-stage renal disease, that also contributes significantly to cardiovascular (CV) disease, and is responsible for much of the morbidity and mortality in such patients. Dapagliflozin is an SGLT2 inhibitor (SGLT2i) which has decrease in the cardiovascular (CV) events.¹

In a prespecified secondary analysis of a trial study, the patients were divided into groups based on the number of CKD (Chronic kidney disease) markers: 

• Two markers if patients had both reduced estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73m2) and albuminuria (UACR(urinary albumin to creatinine ratio) ≥30 mg/g);
• One if patients had either
• none if the  eGFR was ≥ 60 mL/min/1.73m2 and UACR <30 mg/g.¹

The study concluded that if the patients had more CKD markers, there were higher rates of CV events and death. It was observed that Dapagliflozin reduced the absolute risk of CV death in patients with more CKD markers. It was 8.3% among patients having two markers, 1% among patients with one marker, and 0.5 % among patients with none of the markers (p=0.02 for interaction). The reduction in CV events was more in the patient group being treated with Dapagliflozin than in the placebo groups.¹

The FDA has approved dapagliflozin in May 2020 to decrease the risk of cardiovascular (CV) death and hospitalization due to heart failure (HF) in adults. Also, FDA has approved dapagliflozin as the first SGLT2 inhibitor for being used in class II-IV heart failure in patients without T2DM . ²

References:

1. https://specialty.mims.com/topic/dapagliflozin-cuts-cv-events-even-in-patients-with-severe-kidney-disease-?channel=endocrinology&elq_mid=55671&elq_cid=42767
2. https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-type-heart-failure