دورية أكاديمية

Long-term benefits of dapagliflozin on renal outcomes of type 2 diabetes under routine care: a comparative effectiveness study on propensity score matched cohorts at low renal risk

التفاصيل البيبلوغرافية
العنوان: Long-term benefits of dapagliflozin on renal outcomes of type 2 diabetes under routine care: a comparative effectiveness study on propensity score matched cohorts at low renal risk
المؤلفون: Fadini, Gian Paolo, Longato, Enrico, Morieri, Mario Luca, Del Prato, Stefano, Avogaro, Angelo, Solini, Anna, Baldassarre, Maria Pompea Antonia, Consoli, Agostino, Morganet, Sara, Zugaro, Antonella, Baroni, Marco Giorgio, Andreozzi, Francesco, Gatti, Adriano, De Riu, Stefano, Del Buono, Andrea, Aldigeri, Raffaella, Bonadonna, Riccardo, Cas, Alessandra Dei, Vazzana, Angela, Antonini, Monica, Moretti, Valentina, Volsi, Patrizia Li, Cesare, Miranda, Zanette, Giorgio, Carletti, Silvia, D'Angelo, Paola, Leto, Gaetano, Leonetti, Frida, D'Onofrio, Luca, Maddaloni, Ernesto, Buzzetti, Raffaella, Frontoni, Simona, Cavallo, Giselle, Morano, Susanna, Filardi, Tiziana, Capece, Umberto, Giaccari, Andrea, Bossi, Antonio C., Meregalli, Giancarla, Querci, Fabrizio, Gaglio, Alessia, Resi, Veronica, Orsi, Emanuela, Fazion, Stefano, Franzetti, Ivano G., Berra, Cesare, Manfrini, Silvia, Garrapa, Gabriella, Lucarelli, Giulio, Riccialdelli, Lara, Tortato, Elena, Zavattaro, Marco, Aimaretti, Gianluca, Cavalot, Franco, Beccuti, Guglielmo, Broglio, Fabio, Fattor, Bruno, Cazzetta, Giuliana, Lamacchia, Olga, Rauseo, Anna, De Cosmo, Salvatore, Cau, Rosella, Ghiani, Mariangela, Di Benedetto, Antonino, Di Pino, Antonino, Piro, Salvatore, Purrello, Francesco, Frittitta, Lucia, Milluzzo, Agostino, Russo, Giuseppina
المساهمون: Fadini, Gian Paolo, Longato, Enrico, Morieri, Mario Luca, Del Prato, Stefano, Avogaro, Angelo, Solini, Anna, Baldassarre, Maria Pompea Antonia, Consoli, Agostino, Morganet, Sara, Zugaro, Antonella, Baroni, Marco Giorgio, Andreozzi, Francesco, Gatti, Adriano, De Riu, Stefano, Del Buono, Andrea, Aldigeri, Raffaella, Bonadonna, Riccardo, Cas, Alessandra Dei, Vazzana, Angela, Antonini, Monica, Moretti, Valentina, Volsi, Patrizia Li, Cesare, Miranda, Zanette, Giorgio, Carletti, Silvia, D'Angelo, Paola, Leto, Gaetano, Leonetti, Frida, D'Onofrio, Luca, Maddaloni, Ernesto, Buzzetti, Raffaella, Frontoni, Simona, Cavallo, Giselle, Morano, Susanna, Filardi, Tiziana, Capece, Umberto, Giaccari, Andrea, Bossi, Antonio C., Meregalli, Giancarla, Querci, Fabrizio, Gaglio, Alessia, Resi, Veronica, Orsi, Emanuela, Fazion, Stefano, Franzetti, Ivano G., Berra, Cesare, Manfrini, Silvia, Garrapa, Gabriella, Lucarelli, Giulio, Riccialdelli, Lara, Tortato, Elena, Zavattaro, Marco, Aimaretti, Gianluca, Cavalot, Franco, Beccuti, Guglielmo, Broglio, Fabio, Fattor, Bruno, Cazzetta, Giuliana, Lamacchia, Olga, Rauseo, Anna, De Cosmo, Salvatore, Cau, Rosella, Ghiani, Mariangela, Di Benedetto, Antonino, Di Pino, Antonino, Piro, Salvatore, Purrello, Francesco, Frittitta, Lucia, Milluzzo, Agostino, Russo, Giuseppina
سنة النشر: 2024
المجموعة: ARUd'A - Archivio Istituzionale della ricerca dell'università Chieti-Pescara (IRIS)
مصطلحات موضوعية: Chronic kidney disease, Observational, Prevention, SGLT2 inhibitor, Type 2 diabetes
الوصف: Background: Despite the overall improvement in care, people with type 2 diabetes (T2D) experience an excess risk of end-stage kidney disease. We evaluated the long-term effectiveness of dapagliflozin on kidney function and albuminuria in patients with T2D. Methods: We included patients with T2D who initiated dapagliflozin or comparators from 2015 to 2020. Propensity score matching (PSM) was performed to balance the two groups. The primary endpoint was the change in estimated glomerular filtration rate (eGFR) from baseline to the end of observation. Secondary endpoints included changes in albuminuria and loss of kidney function. Findings: We analysed two matched groups of 6197 patients each. The comparator group included DPP-4 inhibitors (40%), GLP-1RA (22.3%), sulphonylureas (16.1%), pioglitazone (8%), metformin (5.8%), or acarbose (4%). Only 6.4% had baseline eGFR <60 ml/min/1.73 m2 and 15% had UACR >30 mg/g. During a mean follow-up of 2.5 year, eGFR declined significantly less in the dapagliflozin vs comparator group by 1.81 ml/min/1.73 m2 (95% C.I. from 1.13 to 2.48; p < 0.0001). The mean eGFR slope was significantly less negative in the dapagliflozin group by 0.67 ml/min/1.73 m2/year (95% C.I. from 0.47 to 0.88; p < 0.0001). Albuminuria declined significantly in new-users of dapagliflozin within 6 months and remained on average 44.3 mg/g lower (95% C.I. from -66.9 to -21.7; p < 0.0001) than in new-users of comparators. New-users of dapagliflozin had significantly lower rates of new-onset CKD, loss of kidney function, and a composite renal outcome. Results were confirmed for all SGLT2 inhibitors, in patients without baseline CKD, and when GLP-1RA were excluded from comparators. Interpretation: Initiating dapagliflozin improved kidney function outcomes and albuminuria in patients with T2D and a low renal risk. Funding: Funded by the Italian Diabetes Society and partly supported by a grant from AstraZeneca.
نوع الوثيقة: article in journal/newspaper
اللغة: English
العلاقة: info:eu-repo/semantics/altIdentifier/pmid/38328413; volume:38; firstpage:100847; journal:THE LANCET REGIONAL HEALTH. EUROPE; https://hdl.handle.net/11564/828513Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85183989035
DOI: 10.1016/j.lanepe.2024.100847
الإتاحة: https://doi.org/10.1016/j.lanepe.2024.100847Test
https://hdl.handle.net/11564/828513Test
رقم الانضمام: edsbas.8EBA3FAD
قاعدة البيانات: BASE