Kidney Week

Abstract: PO2364

DAPA-CKD: A Regional Analysis of Kidney and Cardiovascular Outcomes

Session Information

• CKD: Insights from Recent Clinical Trials and Large Real-World Effectiveness Studies
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Correa-Rotter, Ricardo, The National Medical Science and Nutrition Institute Salvador Zubiran, Mexico City, Mexico

Ricardo Correa-Rotter, MD

• Vart, Priya, University Medical Center Groningen, Groningen, Netherlands

Priya Vart,

• Jongs, Niels, University Medical Center Groningen, Groningen, Netherlands

Niels Jongs,

• Hou, Fan Fan, Southern Medical University, National Clinical Research Center for Kidney Disease, Guangzhou, China

Fan Fan Hou,

• Chertow, Glenn Matthew, Stanford University School of Medicine, Stanford, California, United States

Glenn Matthew Chertow,

• Langkilde, Anna Maria, AstraZeneca, Gothenburg, Sweden

Anna Maria Langkilde,

• McMurray, John, University of Glasgow, Glasgow, Glasgow, United Kingdom

John McMurray,

• Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Peter Rossing,

• Sjostrom, David, AstraZeneca, Gothenburg, Sweden

David Sjostrom,

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

Bergur V. Stefansson,

• Toto, Robert D., UT Southwestern Medical Center, Dallas, Texas, United States

Robert D. Toto,

• Douthat, Walter, Hospital Privado Universitario de Cordoba, Cordoba, Argentina

Walter Douthat,

• Escudero, Elizabeth Teresa, Hospital Arzobispo Loayza, Cayetano Heredia University, Lima, Peru

Elizabeth Teresa Escudero,

• Isidto, Rey A., Healthlink Medical, Dental, Surgical Clinics and Diagnostics Center, Iloilo City, Philippines

Rey A. Isidto,

• Khullar, Dinesh, Max Super Speciality Hospital Saket, New Delhi, Delhi, India

Dinesh Khullar,

• Bajaj, Harpreet S., LMC Diabetes and Endocrinology, Brampton, Ontario, Canada

Harpreet S. Bajaj,

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

David C. Wheeler,

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

Hiddo Jan L Heerspink,

Background

The DAPA-CKD trial (NCT03036150) demonstrated that dapagliflozin reduced the risk of kidney and cardiovascular (CV) events in patients with chronic kidney disease (CKD) and albuminuria, with and without type 2 diabetes. We aimed to determine whether the effects of dapagliflozin varied by pre-specified geographic region.

Methods

We randomized 4304 adults with baseline estimated glomerular filtration rate (eGFR) 25–75 mL/min/1.73m² and urinary albumin-to-creatinine ratio 200–5000 mg/g to dapagliflozin 10mg or placebo once daily; median follow-up was 2.4 years. We compared baseline data, primary and secondary outcomes, and safety of the 4 regions (Asia, Northern America, Latin America, Europe).

Results

Compared to other regions, participants from Asia had lower body mass index, less frequent use of diuretics and better blood pressure control. The figure displays the primary and secondary outcomes by region and treatment assignment. Dapagliflozin consistently reduced the risk of the primary composite endpoint (eGFR decline ≥50%, end-stage kidney disease, or kidney or CV death) across the 4 regions by 30 to 49%, with no significant heterogeneity (p=0.77). Similarly, there was no evidence of differences in secondary outcomes between regions. Serious adverse events in the dapagliflozin and placebo groups were similar across the 4 regions.

Conclusion

Despite differences in patient characteristics, the beneficial effects of dapagliflozin on kidney and CV endpoints in patients with CKD and albuminuria were similar across pre-specified geographic regions.

Funding

• Commercial Support – AstraZeneca