Use of sodium glucose cotransporter 2 (SGLT2) inhibitors to treat type 2 diabetes (T2D) may help to lower the risk of serious kidney problems, according to a study by the BMJ. These findings further support the use of SGLT2 inhibitors in a broad range of patients with T2D, according to the study authors.

Previous clinical trials have shown that SGLT2 inhibitors protect kidney, or renal, function among patients with T2D, but their effect on serious renal events in patients in real-world clinical practice remains unclear.

Researchers used nationwide register data from Sweden, Denmark, and Norway from 2013 to 2018 to compare the use of SGLT2 inhibitors with another group of diabetes drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors.

Prescription data were used to identify 29,887 new users of SGLT2 inhibitors, and 29,887 new users of DPP-4 inhibitors at an average age of 61 years. To track serious renal events over the next 2 years, hospital records and death statistics were used, including renal replacement therapy, death from renal causes, and hospital admission for renal events.

Compared with DPP-4 inhibitors, use of SGLT2 inhibitors was associated with a reduced risk of serious renal events, with 2.6 events per 1000 person years versus 6.2 events per 1000 person years. Further analysis found greater risk reduction in patients with underlying cardiovascular disease and chronic kidney disease, according to the study authors.

Additionally, the study authors noted some study limitations, such as relying on prescription data and hospital records, which may have affected the accuracy of their results. Since the study was conducted in Scandinavia, the findings may not apply to other populations and health care systems, according to the authors.

The study authors concluded that these findings complement the results of previous randomized trials, suggesting that SGLT2 inhibitors may lower the risk of serious renal events in routine clinical practice.

Additional trials in real-world settings and more diverse populations “could add further support for broader access to these drugs, not just in high income countries, but also in lower income countries  where the burden of kidney disease is disproportionately high,” said Steven Smith, MD, co-author of the study, in a press release.

REFERENCE
Certain diabetes drugs may protect against serious kidney problems. BMJ. https://www.bmj.com/company/newsroom/certain-diabetes-drugs-may-protect-against-serious-kidney-problems/. Published April 29, 2020. Accessed May 6, 2020.