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Dedicated kidney disease‐focused outcome trials with sodium‐glucose cotransporter‐2 inhibitors: Lessons from CREDENCE and expectations from DAPA‐HF, DAPA‐CKD, and EMPA‐KIDNEY
Author(s) -
Rhee Jinnie J.,
Jardine Meg J.,
Chertow Glenn M.,
Mahaffey Kenneth W.
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13987
Subject(s) - empagliflozin , canagliflozin , medicine , kidney disease , dapagliflozin , intensive care medicine , clinical trial , randomized controlled trial , diabetes mellitus , diabetic nephropathy , credence , disease , adverse effect , nephropathy , endocrinology , type 2 diabetes , statistics , mathematics
In the past decade, many cardiovascular outcome trials (CVOT) on the efficacy and safety of glucose‐lowering agents have been completed. Amongst newer agents available for treatment of type 2 diabetes mellitus (T2DM), sodium‐glucose cotransporter‐2 (SGLT2) inhibitors have garnered much attention in contemporary clinical practice due to observed benefits on cardiovascular and kidney outcomes among patients with T2DM, as reported in large randomized controlled trials (RCT). These findings are reflected in the updated clinical guidelines of several major professional societies. Herein, we briefly review the mechanism of action of SGLT2 inhibitors and their pleiotropic effects, summarize key findings and limitations of initial CVOTs, then discuss three major kidney disease‐focused outcome trials, including the Canagliflozin and Renal Events in Diabetes and Established Nephropathy Clinical Evaluation (CREDENCE) trial as well as two ongoing RCTs: Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure‐chronic kidney disease and EMPA‐KIDNEY.