Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty

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Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty. / Vart, Priya; Butt, Jawad H; Jongs, Niels; Schechter, Meir; Chertow, Glenn M; Wheeler, David C; Pecoits-Filho, Roberto; Langkilde, Anna Maria; Correa-Rotter, Ricardo; Rossing, Peter; McMurray, John J V; Heerspink, Hiddo J L.

I: Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, Bind 79, Nr. 2, 2024.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Vart, P, Butt, JH, Jongs, N, Schechter, M, Chertow, GM, Wheeler, DC, Pecoits-Filho, R, Langkilde, AM, Correa-Rotter, R, Rossing, P, McMurray, JJV & Heerspink, HJL 2024, 'Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty', Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, bind 79, nr. 2. https://doi.org/10.1093/gerona/glad181

APA

Vart, P., Butt, J. H., Jongs, N., Schechter, M., Chertow, G. M., Wheeler, D. C., Pecoits-Filho, R., Langkilde, A. M., Correa-Rotter, R., Rossing, P., McMurray, J. J. V., & Heerspink, H. J. L. (2024). Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty. Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, 79(2). https://doi.org/10.1093/gerona/glad181

Vancouver

Vart P, Butt JH, Jongs N, Schechter M, Chertow GM, Wheeler DC o.a. Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty. Journals of Gerontology. Series A: Biological Sciences & Medical Sciences. 2024;79(2). https://doi.org/10.1093/gerona/glad181

Author

Vart, Priya ; Butt, Jawad H ; Jongs, Niels ; Schechter, Meir ; Chertow, Glenn M ; Wheeler, David C ; Pecoits-Filho, Roberto ; Langkilde, Anna Maria ; Correa-Rotter, Ricardo ; Rossing, Peter ; McMurray, John J V ; Heerspink, Hiddo J L. / Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty. I: Journals of Gerontology. Series A: Biological Sciences & Medical Sciences. 2024 ; Bind 79, Nr. 2.

Bibtex

@article{04118fcadc394788a640426b002b6ad2,
title = "Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty",
abstract = "BACKGROUND: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level.METHODS: Adults with CKD, with/without type 2 diabetes, with estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio 200-5000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was composite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD) or death from kidney or cardiovascular (CV) causes.RESULTS: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4303/4304 (99.9%) patients: 1162 (27.0%) in not-to-mildly frail(FI≤0.210), 1642 (38.2%) in moderately frail(FI 0.211-0.310), and 1499 (34.8%) in severely frail categories (FI>0.311). Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% CI]: 0.50 [0.33-0.76], 0.62 [0.45-0.85], and 0.64 [0.49-0.83], respectively (P-interaction =0.67). Results were similar for secondary outcomes including kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; P-interaction=0.44), CV endpoint (heart failure hospitalization or CV death; P-interaction=0.63), and all-cause mortality (P-interaction p=0.42). Results were consistent when using FI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin vs. placebo in all FI categories (16.9% vs. 20.1%, 26.3% vs. 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately and severely frail categories, respectively).CONCLUSIONS: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety.",
author = "Priya Vart and Butt, {Jawad H} and Niels Jongs and Meir Schechter and Chertow, {Glenn M} and Wheeler, {David C} and Roberto Pecoits-Filho and Langkilde, {Anna Maria} and Ricardo Correa-Rotter and Peter Rossing and McMurray, {John J V} and Heerspink, {Hiddo J L}",
note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.",
year = "2024",
doi = "10.1093/gerona/glad181",
language = "English",
volume = "79",
journal = "Journals of Gerontology. Series A: Biological Sciences & Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "2",

}

RIS

TY - JOUR

T1 - Efficacy and Safety of Dapagliflozin in Patients with Chronic Kidney Disease across the Spectrum of Frailty

AU - Vart, Priya

AU - Butt, Jawad H

AU - Jongs, Niels

AU - Schechter, Meir

AU - Chertow, Glenn M

AU - Wheeler, David C

AU - Pecoits-Filho, Roberto

AU - Langkilde, Anna Maria

AU - Correa-Rotter, Ricardo

AU - Rossing, Peter

AU - McMurray, John J V

AU - Heerspink, Hiddo J L

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.

PY - 2024

Y1 - 2024

N2 - BACKGROUND: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level.METHODS: Adults with CKD, with/without type 2 diabetes, with estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio 200-5000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was composite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD) or death from kidney or cardiovascular (CV) causes.RESULTS: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4303/4304 (99.9%) patients: 1162 (27.0%) in not-to-mildly frail(FI≤0.210), 1642 (38.2%) in moderately frail(FI 0.211-0.310), and 1499 (34.8%) in severely frail categories (FI>0.311). Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% CI]: 0.50 [0.33-0.76], 0.62 [0.45-0.85], and 0.64 [0.49-0.83], respectively (P-interaction =0.67). Results were similar for secondary outcomes including kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; P-interaction=0.44), CV endpoint (heart failure hospitalization or CV death; P-interaction=0.63), and all-cause mortality (P-interaction p=0.42). Results were consistent when using FI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin vs. placebo in all FI categories (16.9% vs. 20.1%, 26.3% vs. 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately and severely frail categories, respectively).CONCLUSIONS: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety.

AB - BACKGROUND: A sizeable proportion of patients with chronic kidney disease (CKD) are reported to be frail. Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level.METHODS: Adults with CKD, with/without type 2 diabetes, with estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73m 2 and urinary albumin-to-creatinine ratio 200-5000 mg/g were randomized to dapagliflozin (10 mg/day) or placebo. The primary endpoint was composite of sustained ≥50% eGFR decline, end-stage kidney disease (ESKD) or death from kidney or cardiovascular (CV) causes.RESULTS: Frailty index (FI), assessed by Rockwood cumulative deficit approach, was calculable in 4303/4304 (99.9%) patients: 1162 (27.0%) in not-to-mildly frail(FI≤0.210), 1642 (38.2%) in moderately frail(FI 0.211-0.310), and 1499 (34.8%) in severely frail categories (FI>0.311). Dapagliflozin reduced the risk of the primary composite endpoint across all FI categories (hazard ratios [95% CI]: 0.50 [0.33-0.76], 0.62 [0.45-0.85], and 0.64 [0.49-0.83], respectively (P-interaction =0.67). Results were similar for secondary outcomes including kidney composite outcome (sustained ≥50% eGFR decline, ESKD or death from kidney cause; P-interaction=0.44), CV endpoint (heart failure hospitalization or CV death; P-interaction=0.63), and all-cause mortality (P-interaction p=0.42). Results were consistent when using FI as a continuous variable. Occurrence of serious adverse events was numerically lower in patients receiving dapagliflozin vs. placebo in all FI categories (16.9% vs. 20.1%, 26.3% vs. 30.7%, and 42.9% vs 47.8%, in not-to-mildly, moderately and severely frail categories, respectively).CONCLUSIONS: The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety.

U2 - 10.1093/gerona/glad181

DO - 10.1093/gerona/glad181

M3 - Journal article

C2 - 37527836

VL - 79

JO - Journals of Gerontology. Series A: Biological Sciences & Medical Sciences

JF - Journals of Gerontology. Series A: Biological Sciences & Medical Sciences

SN - 1079-5006

IS - 2

ER -

ID: 381061523