A new study provides the first comprehensive safety profile of SGLT2 inhibitors in US patients with CKD and type 2 diabetes receiving routine care and suggests that the benefits outweigh the risks.
SGLT2 inhibitors are recommended as first-line therapy in patients with type 2 diabetes and CKD who have an eGFR ≥ 20 mL/min/1.73 m, and thus are at high risk for cardiovascular disease and kidney disease progression, Fu and colleagues write.
This slow uptake of SGLT2 inhibitors among patients with CKD may be partly due to concerns about DKA, fractures, amputations, and urogenital infections observed in clinical trials. To examine this, the researchers identified health insurance claims data from 96,128 individuals who were 18 years or older and had type 2 diabetes and at least one inpatient or two outpatient diagnostic codes for stage 3 or 4 CKD.
The researchers matched 28,847 individuals who were initiated on an SGLT2 inhibitor with an equal number who were initiated on a GLP-1 agonist, based on propensity scores, adjusting for more than 120 baseline characteristics.Patients who were initiated on an SGLT2 inhibitor had 1.30-fold, 2.13-fold, and 3.
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