Abstract: SA-PO1136
Real-World SGLT2 Inhibitor (SGLT2i) Use in Patients with CKD in Japan
Session Information
- CKD: Progression, Drugs, Modalities, and Environmental Factors
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama Prefecture, Japan
- Frankel, Andrew H., Imperial College London, London, England, United Kingdom
- Kovesdy, Csaba P., The University of Tennessee Medical Center, Knoxville, Tennessee, United States
- Du, Chengan, Boehringer Ingelheim Corp USA, Ridgefield, Connecticut, United States
- Kato, Sota, Nippon Boehringer Ingelheim Kabushiki Kaisha, Shinagawa, Tokyo, Japan
- Hunnicutt, Jake, Boehringer Ingelheim Corp USA, Ridgefield, Connecticut, United States
Background
Approximately 13 million people in Japan have CKD, which is associated with severe cardiometabolic comorbidities including type 2 diabetes (T2D) and heart failure (HF). Real-world treatment patterns in Japan prior to approval of the SGLT2i empagliflozin for CKD are unclear.
Methods
We assessed Japanese adults (>18 years) with ICD-10-diagnosed CKD (any stage) using the JMDC database of commercial health insurance claims. Demographics, comorbidities and prescriptions for SGLT2i and other therapies were captured in the year preceding local approval of empagliflozin for CKD (Feb 9, 2024), stratified by presence of comorbidities (T2D and/or HF) and stage G3–5 CKD (by estimated glomerular filtration rate [eGFR], in patients with available data), and were reported descriptively.
Results
Overall, 80,928 patients with CKD were identified (median [IQR] age: 57 [50–63] years; 71.1% male; 58.1% had eGFR data available, of which 14.5% had G3–5 CKD) (Table). Of these, 50.8% had CKD only, 30.4% had CKD+T2D, 12.6% had CKD+HF and 6.2% had CKD+T2D+HF; age and sex were broadly similar across subgroups. SGLT2i were prescribed to 30.7% of patients (from 18.1% [CKD only] to 51.9% [CKD+T2D+HF]), and renin–angiotensin system inhibitors (RASi) to 37.7% of patients (from 32.3% [CKD+T2D] to 57.7% [G3–5 CKD]). Other CKD-related medications including finerenone and mineralocorticoid receptor agonists (MRAs) were rarely used but were most frequently prescribed in patients with HF.
Conclusion
In the year preceding local approval of empagliflozin for CKD, SGLT2i use in Japanese clinical practice appeared suboptimal (including in patients with G3–5 CKD). Use of other CKD-related medications appeared to broadly reflect recommended management of CKD with/without cardiometabolic comorbidities.
Table
Funding
- Commercial Support – Boehringer Ingelheim & Eli Lilly and Company Alliance