When assessing the renal endpoint, investigators found also consistently reduced the risk of the kidney-specific composite outcome regardless of the concomitant use of cardiovascular medications except for diuretics ( P >.05 for each interaction). Additionally, the association did not differ between those with concurrent use of all 3 other cardiovascular medications and those using 2 or fewer of these medications P >.05 for interaction). Initial analyses demonstrated there were no differences in the effects of dapagliflozin on blood pressure and eGFR from baseline to 48 months relative to placebo therapy based on background medications (placebo-corrected change, −1.6 mmHg to −2.6 mmHg P >.05 for each interaction).įurther analysis suggested dapagliflozin use consistently reduced the risk of cardiovascular death and heart failure hospitalization regardless of the background use of CV medications, including ACEiARBs, β-blockers, diuretics, and MRAs ( P >.05 for each interaction). Investigators pointed out no patients were taking sacubitril/valsartan at the time as the agent had not yet received regulatory approval. Of the 17,160 patients included in DECLARE-TIMI 58, 81% reported use of ACEi/ARBs, 53% used β-blockers, 36% used diuretics, and 4% used MRAs at baseline. The outcomes of interest for the current analyses were the composite of CV death or hospitalization for heart failure, hospitalization for heart failure alone, and a kidney-specific composite outcome, which consisted of a 40% decline in eGFR, end-stage kidney disease, or kidney-related death. With primary endpoints of major adverse cardiovascular events (MACE) and a composite of cardiovascular death or hospitalization for heart failure, results of the study demonstrated use of dapagliflozin did not result in a lower rate of MACE (HR, 0.93 P=.17) but did result in a lower rate of cardiovascular death or hospitalization for heart failure (HR, 0.83 P=.005).įor the current study, investigators sought to compare the effects of dapagliflozin against placebo therapy in patient subgroups stratified by baseline use of ACEI/ARBs, β-blockers, diuretics, and mineralocorticoid receptor antagonists (MRAs). A prespecified secondary analysis of DECLARE-TIMI 58, the current study was designed with the intent of furthering the knowledge base surrounding the efficacy and safety profile of dapagliflozin, based on concurrent use of other cardiovascular medications, in patients with type 2 diabetes.Ī randomized, double-blind, multinational trial, DECLARE-TIMI 58 randomized 17,160 patients with type 2 diabetes and either established atherosclerotic cardiovascular disease (ASCVD) or multiple risk factors for ASCVD and with a creatinine clearance of 60 mL/min or greater to either placebo therapy or dapagliflozin. In recent years, a multitude of clinical trials have outlined the safety and efficacy of SGLT2 inhibitors in patient populations with and without type 2 diabetes for heart failure and chronic kidney disease.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |