TY - JOUR
T1 - SGLT2 inhibitors’ interaction with other renoactive drugs in type 2 diabetes patients: still a lot to learn
AU - van Baar, Michaël J. B.
AU - Scholtes, Rosalie A.
AU - van Raalte, Daniël H.
PY - 2019
Y1 - 2019
N2 - The first cardiovascular (CV) safety trial conducted with a sodium-glucose cotransporter (SGLT)-2 inhibitor, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients—Removing Excess Glucose (EMPA-REG OUTCOME), reported not only remarkable risk reductions in CV outcome, but also impressive improvements in renal outcome. Changes in renal hemodynamics could be involved in the benefit of SGLT2 inhibitors on renal outcomes. Considering that all patients of EMPA-REG OUTCOME had established atherosclerotic CV disease at baseline, many patients were also treated with several CV drugs at baseline, including RAS blockers, diuretics, calcium-channel blockers, and nonsteroidal anti-inflammatory drugs. These drugs also impact renal physiology and possibly renal outcome, which could cause relevant drug–drug interactions. This topic is addressed in this issue of Kidney International by Mayer and colleagues. In their manuscript, the impact of empagliflozin on kidney function, renal outcome, and renal safety is presented with stratification for background therapy. Although the beneficial effects of empagliflozin and its safety profile are consistent among all groups, we wonder, do we really understand the renal effects of all these drugs in type 2 diabetes (T2D) patients as studied in the large outcome trials?
AB - The first cardiovascular (CV) safety trial conducted with a sodium-glucose cotransporter (SGLT)-2 inhibitor, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients—Removing Excess Glucose (EMPA-REG OUTCOME), reported not only remarkable risk reductions in CV outcome, but also impressive improvements in renal outcome. Changes in renal hemodynamics could be involved in the benefit of SGLT2 inhibitors on renal outcomes. Considering that all patients of EMPA-REG OUTCOME had established atherosclerotic CV disease at baseline, many patients were also treated with several CV drugs at baseline, including RAS blockers, diuretics, calcium-channel blockers, and nonsteroidal anti-inflammatory drugs. These drugs also impact renal physiology and possibly renal outcome, which could cause relevant drug–drug interactions. This topic is addressed in this issue of Kidney International by Mayer and colleagues. In their manuscript, the impact of empagliflozin on kidney function, renal outcome, and renal safety is presented with stratification for background therapy. Although the beneficial effects of empagliflozin and its safety profile are consistent among all groups, we wonder, do we really understand the renal effects of all these drugs in type 2 diabetes (T2D) patients as studied in the large outcome trials?
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85068752007&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31331468
U2 - https://doi.org/10.1016/j.kint.2019.03.032
DO - https://doi.org/10.1016/j.kint.2019.03.032
M3 - Comment/Letter to the editor
C2 - 31331468
SN - 0085-2538
VL - 96
SP - 283
EP - 286
JO - Kidney International
JF - Kidney International
IS - 2
ER -