Kidney Week

Abstract: SA-OR087

Correction of Anemia by Dapagliflozin in Patients with T2D

Session Information

• Moving the Needle for Treatment of Diabetic Kidney Disease
  November 09, 2019 | Location: Ballroom C, Walter E. Washington Convention Center
  Abstract Time: 06:18 PM - 06:30 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Stefansson, Bergur V., AstraZeneca, Gothenburg, Sweden

Bergur V. Stefansson, MD, PhD



Bergur Stefánsson is a Senior Research Physician and Medical Lead in Chronic Kidney Disease at AstraZeneca. His recent published work includes the DELIGHT study; “Albuminuria-lowering effect of dapagliflozin alone and in combination with saxagliptin and effect of dapagliflozin and saxagliptin on glycaemic control in patients with type 2 diabetes and chronic kidney disease”, “Correction of hypomagnesemia by dapagliflozin in patients with type 2 diabetes: A post hoc analysis of 10 randomized, placebo-controlled trials”, and “Prediction of the effect of dapagliflozin on kidney and heart failure outcomes based on short-term changes in multiple risk markers”. He received his Ph.D in Renal Anemia from University of Gothenburg and worked as a Nephrologist at Sahlgrenska University Hospital for 17 years.

• L Heerspink, Hiddo Jan, University Medical Center Groningen, Groningen, Netherlands

Hiddo Jan L Heerspink,

• Wheeler, David C., University College London, London, United Kingdom

David C. Wheeler,

• Sjostrom, David, AstraZeneca, Gothenburg, Sweden

David Sjostrom,

• Greasley, Peter J., AstraZeneca, Gothenburg, Sweden

Peter J. Greasley,

• Sartipy, Peter, AstraZeneca, Gothenburg, Sweden

Peter Sartipy,

• Correa-Rotter, Ricardo, Institutor Nacional de la Nutricion, Mexico City, Mexico

Ricardo Correa-Rotter,

Background

Type 2 diabetes (T2D) is one of the most common causes of chronic kidney disease (CKD) and the most frequent cause of renal anemia. Most patients (pts) with T2D show no overt symptoms of renal impairment, consequently, unrecognized anemia is common. Increased hemoglobin (Hb) levels have been observed with dapagliflozin (DAPA) treatment. This study investigated the efficacy and safety of DAPA 10mg in pts with and without anemia at baseline.

Methods

This post-hoc analysis evaluated the effect of the sodium-glucose cotransporter 2 inhibitor, DAPA 10mg, on Hb over 24 weeks (w) across 14 placebo (PBO)-controlled studies in T2D pts with or without anemia (women Hb<12.0 g/dL; men Hb<13.0 g/dL).

Results

A total of 5324 pts were included, 700 (13%) pts had anemia at baseline. There were 1168 (22%) pts with CKD (eGFR<60 mL/min/1.73m²), 324 (28%) had anemia at baseline. As expected, pts with anemia vs those without anemia were older (mean age:63 vs 59y), had a longer duration of T2D (14 vs 9y) and more advanced CKD (mean eGFR: 66.3 vs 78.6 mL/min/1.73m² and mean UACR: 274 vs 89 mg/g). Longitudinal repeated measures analysis showed an Hb increase at w 24 in the DAPA 10mg anemia and no-anemia subgroups (Fig.1A). Anemia: (Mean g/dL(SEM)[95% CI], DAPA 0.81(0.066)[0.68,0.93], PBO 0.28(0.067)[0.15,0.41]; difference vs PBO 0.53(0.076)[0.38,0.68]). No-anemia: (DAPA 0.56(0.017)[0.53,0.60] and PBO -0.20(0.018)[-0.23,-0.16]; Difference vs PBO 0.76(0.024)[0.72, 0.81]). DAPA 10mg corrected anemia in more pts than PBO; DAPA 10mg 52% vs PBO 26% (Fig.1B). Overall, DAPA 10mg was well tolerated.

Conclusion

Unrecognized anemia is common in pts with T2D. DAPA 10mg corrected anemia by increasing Hb over 24w and was well tolerated. This effect may be driven by a reduction in blood volume but the increase in Hb beyond w 4 may be explained by other mechanisms.

The effect of DAPA 10mg on Hb in pts with and without anemia over 24 weeks

Funding

• Commercial Support –