Effects of dapagliflozin on renal function in type 1 diabetes patients in the real world: A retrospective multicenter study of the KAMOGAWA-A cohort

Hironaka, Junya; Okada, Hiroshi; Hamaguchi, Masahide; Sakai, Kimiko; Minamida, Megumi; Kondo, Yuriko; Hashimoto, Yoshitaka; Kitagawa, Noriyuki; Yano, Miho; Yamazaki, Masahiro; Hasegawa, Goji; Horiguchi, Go; Teramukai, Satoshi; Fukui, Michiaki

doi:10.1016/j.diabres.2023.110794

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…At the same time, individuals treated with SGLT inhibitors were 51% less likely to develop CKD compared to those treated with GLP-1 RAs [ 24 ]. Finally, in a retrospective, multicenter cohort study investigating the effects of 24-month dapagliflozin treatment on renal function among 295 T1D individuals, dapagliflozin users experienced a significantly smaller decrease in eGFR levels than non-users [ 25 ]. In addition, the median change in UACR differed significantly between dapagliflozin users and non-users [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…SGLT inhibitors exert significant benefit in terms of albuminuria reduction and a non-significant effect on eGFR levels in patients with T1D, when added to standard insulin treatment. Future, large, well-designed, renal outcome trials are required to shed further light on their exact place in the treatment of patients with T1D, with emphasis on the prevention or delaying of CKD, which still represents a major complication in clinical practice affecting life and its quality for patients with T1D [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Sodium–Glucose Cotransporter Inhibitors on Renal Function as Adjunctive to Insulin in Adults with Type 1 Diabetes: An Updated Multilevel Meta-analysis of Randomized Controlled Trials

Karakasis,

Popovic,

Patoulias

et al. 2024

Diabetes Ther

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Introduction This systematic review aimed to summarize the existing evidence from published randomized controlled trials (RCTs) on the impact of sodium–glucose cotransporter (SGLT) inhibitors on albuminuria levels and renal function in patients with type 1 diabetes mellitus (T1D). Methods The literature search was performed through Medline (via PubMed), Cochrane Library, and Scopus until November 11, 2023. Double-independent study selection, data extraction, and quality assessment were performed. Evidence was pooled with three-level mixed-effects meta-analysis. Results In total, 5221 participants with T1D among 11 RCTs were analyzed. All RCTs had low risk of bias according to the Cochrane Collaboration tool (RoB 2). SGLT inhibitors were associated with a significantly greater reduction in urine albumin-to-creatinine ratio (UACR) compared to controls (MD = − 23.13%; 95% CI = [− 33.69, − 12.57]; P < 0.001; level of evidence high). On the basis of subgroup analysis, this effect was consistent across all available SGLT inhibitors, irrespective of the dosage. Finally, a neutral class effect was observed on the estimated glomerular filtration rate (eGFR, MD = − 1.03 mL/min/1.73 m 2 ; 95% CI = [− 2.26, 0.19]; P = 0.1; level of evidence moderate). Only empagliflozin was associated with a significant reduction in eGFR compared to placebo (MD = − 2.23 mL/min/1.73 m 2 ; 95% CI = [− 3.62, − 0.84]; P = 0.002). Conclusion Our findings suggest that adjunctive therapy with SGLT inhibitors results in a significant reduction in albuminuria, while their use is associated with a neutral effect on creatinine clearance, as a measure of renal function. Future renal outcome trials are needed to assess SGLT inhibitors’ role in the pharmacological armamentarium against diabetic nephropathy in T1D. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-023-01523-0.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effect of Sodium–Glucose Cotransporter Inhibitors on Renal Function as Adjunctive to Insulin in Adults with Type 1 Diabetes: An Updated Multilevel Meta-analysis of Randomized Controlled Trials

Karakasis,

Popovic,

Patoulias

et al. 2024

Diabetes Ther

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“…Гипотетический расчет для пациентов с СД1, получавших дапаглифлозин, показал бы задержку в достижении терминальной ХБП (рСКФ <15 мл/мин) примерно на 15 лет. Кроме того, HbA1c, общая доза инсулина и соотношение альбумина к креатинину в моче также были ниже, а частота диабетического кетоацидоза и госпитализаций по поводу гипогликемии неизменны в группе дапаглифлозина [30].…”

Section: нефропротективные эффектыunclassified

Expanding Indications for the Sodium-Cotransporter Glucose 2 Inhibitors Application in Type 2 Diabetes Mellitus

Мохорт

2024

Рецепт

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Ингибиторы натриевого котранспортера глюкозы 2 (ИНКТГ2) широко используются в лечении сахарного диабета 2-го типа (СД2). На примере ИНКТГ2 дапаглифлозина продемонстрированы дополнительные преимущества препарата, включающие наряду с улучшением компенсации СД2 без риска гипогликемических эпизодов снижение кардиоваскулярного риска, вероятности развития и ухудшения течения сердечной недостаточности, артериального давления, уменьшение риска фибрилляции предсердий, ренопротективные эффекты c минимизацией риска развития анемии, влияние на неалкогольную жировую болезнь печени, снижение уровня мочевой кислоты и др. Перечисленные преимущества результируются в потенциальное увеличение продолжительности жизни. Приведенные факты определяют расширение показаний для использования ИНКТГ2 и представителя класса – дапаглифлозина. Sodium glucose cotransporter inhibitors 2 (SGLT2 I) are widely used in the type 2 diabetes mellitus (DM2) treatment. Using the example of SGLT2 I dapagliflozin, additional benefits of the drug have been demonstrated, including, along with improved compensation for DM2 without hypoglycemic episodes risks, a decrease in cardiovascular risk, the likelihood of developing and worsening the course of heart failure, blood pressure, a decrease in the risk of atrial fibrillation, renoprotective effects with minimizing of the anemia, the influence on non-alcoholic fatty liver disease, a decrease in uric acid levels and others. These benefits result in a potential increase in life expectancy. These facts determine the expansion of indications for the application of SGLT2 I and a representative of the class – dapagliflozin.

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Real-world safety and effectiveness of dapagliflozin in people living with type 1 diabetes in Spain: The Dapa-ON multicenter retrospective study

Durán-Martínez,

Azriel,

Doulatram-Gamgaram

et al. 2024

Diabetes & Metabolism

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Effects of dapagliflozin on renal function in type 1 diabetes patients in the real world: A retrospective multicenter study of the KAMOGAWA-A cohort

Cited by 3 publications

References 16 publications

The Effect of Sodium–Glucose Cotransporter Inhibitors on Renal Function as Adjunctive to Insulin in Adults with Type 1 Diabetes: An Updated Multilevel Meta-analysis of Randomized Controlled Trials

The Effect of Sodium–Glucose Cotransporter Inhibitors on Renal Function as Adjunctive to Insulin in Adults with Type 1 Diabetes: An Updated Multilevel Meta-analysis of Randomized Controlled Trials

Expanding Indications for the Sodium-Cotransporter Glucose 2 Inhibitors Application in Type 2 Diabetes Mellitus

Real-world safety and effectiveness of dapagliflozin in people living with type 1 diabetes in Spain: The Dapa-ON multicenter retrospective study

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