New data show empagliflozin slows GFR, maintains ejection fraction in CKD, heart failure
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Patients with chronic kidney disease and heart failure who took the sodium glucose co-transporter 2 inhibitor empagliflozin saw a stabilization of ejection fraction and a slowing in eGFR decline, according to trial results presented here.
Data from the EMPEROR-Preserved trial also showed empagliflozin was effective in lowering cardiovascular deaths and heart failure-related hospitalizations compared with placebo, Faiez Zannad, MD, PhD, of the Université de Lorraine, Inserm INI-CRCT, CHRU, Nancy, France, said during a presentation of results at ASN Kidney Week.
“As part of the active, and so far, disappointing quest for a therapy to help patients with [heart failure with preserved ejection fraction] HFpEF, the EMPEROR-Preserved trial is the first trial showing unequivocal cardiac and renal benefits in such patients,” Zannad said. “This trial reproduces the same benefits also observed in patients with heart failure and reduced ejection fraction. Therefore, empagliflozin is the first drug ever showing a consistent improvement of cardiovascular outcomes and a slowing of kidney function decline across the full spectrum of kidney function, including patients with chronic kidney disease, across the full spectrum of cardiac ejection fraction and in patients with and without diabetes,” he said.
Zannad said empagliflozin was effective in patients with CKD in the EMPEROR-Preserved trial in stabilizing eGFRs as low as 20 mL/min/1.73 m2.
In results presented last year at ASN Kidney Week, patients in the EMPEROR-Reduced trial experienced a modest eGFR decrease with use of empagliflozin vs. placebo.
“However, in the placebo group, patients in whom early post-treatment initiation eGFR decreased had a higher risk of sustained worsening kidney function compared to patients in whom eGFR increased,” Zannad and colleagues reported at this year’s ASN Kidney Week. “Any post-empagliflozin initiation decrease in eGFR did not deprive patients from benefiting from empagliflozin therapy.”
Of the 5,988 patients randomized to either empagliflozin or placebo in the EMPEROR-Preserved trial, 53% had prevalent CKD, Zannad and colleagues reported.
Jardiance (empagliflozin; 10 mg) was approved by the FDA to reduce the risk of cardiovascular death and hospitalization in adults with heart failure and reduced ejection fraction.
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Zannad F, et al. Paper FR-OR67. Presented at the ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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