Trending Clinical Topics for May 2019

Ryan Syrek

Disclosures

May 31, 2019

Trending Clinical Topic of the Week (May 4-10): SGLT2 Inhibitors

A potential game changer in the treatment of patients with diabetic nephropathy is this week's top trending clinical topic. Results of the CREDENCE trial were published recently. The study included 4401 patients with diabetic nephropathy who were randomly assigned to receive either canagliflozin (an oral SGLT2 inhibitor) or a placebo. In patients with type 2 diabetes and kidney disease, the risk for kidney failure among patients who received canagliflozin was 30% lower than among those who received placebo. The SGLT2 inhibitor also significantly lowered the risk for major cardiovascular events, including death and hospitalization for heart failure.

The news was met with much enthusiasm from those who care for patients with diabetic kidney disease. The last major advance in the treatment of these patients—the advent of renin-angiotensin-aldosterone system (RAAS) blockers—occurred  about 18 years ago. As such, canagliflozin is being hailed as a "home run" for curtailing kidney failure risk in these patients. Although the impact of the study is still being evaluated, one expert remarked that he "can't remember a kidney disease trial stopped for overwhelming benefit," which is what occurred in CREDENCE. The US Food and Drug Administration  has already approved the SGLT2 inhibitor dapagliflozin for use in patients with type 2 diabetes and moderate renal impairment. When terms like "landmark," "breathtaking," and "practice-changing" are associated with a treatment option, as they have been with SGLT2 inhibitors, that medication is likely to become a top trending clinical topic.

Read more information on diabetic nephropathy.

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