Empagliflozin (Jardiance), an SGLT2 inhibitor used to treat type 2 diabetes, may slow the progression of renal disease in diabetics at risk for cardiovascular disease. In a recently published, industry-sponsored study, patients with type 2 diabetes and a glomerular filtration rate of at least 30 mL/min/1.73 m2 were randomly assigned to empagliflozin (10 or 25 mg/day) or placebo. Incident or worsening nephropathy occurred in 12.7% of the empagliflozin group (525 of 4,124) and 18.8% of the placebo group (388 of 2061; hazard ratio, 0.61; 95% confidence interval, 0.53-0.70; P < 0.001). Doubling of serum creatinine occurred, and renal replacement therapy was twice as common in the placebo group. The authors concluded, “In patients with type 2 diabetes at high cardiovascular risk, empagliflozin was associated with slower progression of kidney disease and lower rates of clinically relevant renal events than was placebo when added to standard care.” (N Engl J Med. Published online June 14, 2016. DOI: 10.1056/NEJMoa1515920). Interestingly, two other SGLT2 inhibitors are the subject of a new FDA warning regarding worsening renal function.
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