Will Herrington, MBBS, MD, MA: Empagliflozin Follow-up Data Informs Clinical Care for CKD

Empagliflozin continued to benefit cardiorenal outcomes for about 1 year after discontinuation in patients with chronic kidney disease (CKD), according to post-trial follow-up data (PTFU) from the phase 3 EMPA-KIDNEY trial.

by Will Herrington, MA, MBBS, MD, Professor of Trials and Epidemiology of Kidney Disease, Renal Studies Group, Nuffield Department of Population Health, and practicing Honorary Consultant Nephrologist, Oxford Kidney Unit, Oxford University, presented data this week from the PTFU at The American Society of Nephrology (ASN) Kidney Week 2024 in San Diego, California.

“We weren't expecting to see such a substantial carryover effect… not just for the primary outcomes, kidney function related outcomes… [but also] death or end stage kidney disease,” Herrington told HCPLive.

He noted surprising findings from the PTFU demonstrating a continued benefit from the drug until about a year after discontinuation. Particularly, kidney disease progression or cardiovascular death occurred in 865/3305 (26.2%) participants that received empagliflozin and 1001/3305 (30.3%) that received placebo over the entirety of follow-up (hazard ratio [HR], 0.79 [95% CI, 0.72-0.87]). Post-trial, participants that received empagliflozin had a 13% reduction (HR, 0.87 [95% CI, 0.76-0.99]) in the risk of kidney disease progression or cardiovascular death.

“The corollary of all of this means that the drug is safe. The drug works, it will continue to work for about a year after you stop taking it. But if you stop taking it for more than a year, then you lose all of the benefits… We should be ensuring our patients stay on the drug at the at the full dose long term to ensure we maximize their benefits,” Herrington said.

REFERENCE

Herrington WG, Staplin N, Agrawal R, Haynes R, Renal Studies Group. Long-Term Effects of Empagliflozin in CKD. Presented at: ASN Kidney Week 2024, October 13-26; San Diego, California.