Diabetes, obesity & metabolism · 2025
Effects of SGLT2 inhibitors on development and progression of kidney disease in Chinese patients with type 2 diabetes: A multicentre, prospective real-world study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Yun, Wang Yajing, Mu Yiming, Cheng Yu
Аннотация
AIMS: We aimed to compare renal outcomes between patients with type 2 diabetes mellitus (T2DM) who were treated with sodium-glucose cotransporter 2 (SGLT2) inhibitors and those on other glucose-lowering drugs under routine clinical practice.
MATERIALS AND METHODS: IMPROVE was a multicentric, observational, prospective real-world study conducted across 45 hospitals in China. Eligible patients were adults ≥18 years with T2DM for ≥12 months who were currently taking SGLT2 inhibitors or other glucose-lowering drugs. Blood and urine samples were collected at baseline and 6 months. The primary endpoint was the rate of change of eGFR compared with the baseline level after 6 months.
RESULTS: The study took place between September 2021 and September 2023. At baseline, mean glycated haemoglobin was 8.33%, and mean eGFR was 114.68 mL/min/1.73 m2. Among 5562 patients completing 6 months follow-up, the mean eGFR change was +1.2 mL/min/1.73 m2 in the SGLT2 inhibitors group versus -6.0 mL/min/1.73 m2 in controls (difference 8.0, 95% CI 5.7-10.4; p < 0.0001). In the SGLT2 inhibitors group, the risk of an eGFR decline ≥25% was 18.9%, lower than the 22.8% observed in controls (RR 0.83, 95% CI 0.78-0.87). The composite outcome of improved glycaemic control plus stable renal function was achieved in 39.1% versus 35.0% (RR 1.12, 95% CI 1.06-1.18).
CONCLUSIONS: In this Chinese real-world study of patients with T2DM, treatment with SGLT2 inhibitors was associated with a slower decline in kidney function compared with other glucose-lowering drugs.
MATERIALS AND METHODS: IMPROVE was a multicentric, observational, prospective real-world study conducted across 45 hospitals in China. Eligible patients were adults ≥18 years with T2DM for ≥12 months who were currently taking SGLT2 inhibitors or other glucose-lowering drugs. Blood and urine samples were collected at baseline and 6 months. The primary endpoint was the rate of change of eGFR compared with the baseline level after 6 months.
RESULTS: The study took place between September 2021 and September 2023. At baseline, mean glycated haemoglobin was 8.33%, and mean eGFR was 114.68 mL/min/1.73 m2. Among 5562 patients completing 6 months follow-up, the mean eGFR change was +1.2 mL/min/1.73 m2 in the SGLT2 inhibitors group versus -6.0 mL/min/1.73 m2 in controls (difference 8.0, 95% CI 5.7-10.4; p < 0.0001). In the SGLT2 inhibitors group, the risk of an eGFR decline ≥25% was 18.9%, lower than the 22.8% observed in controls (RR 0.83, 95% CI 0.78-0.87). The composite outcome of improved glycaemic control plus stable renal function was achieved in 39.1% versus 35.0% (RR 1.12, 95% CI 1.06-1.18).
CONCLUSIONS: In this Chinese real-world study of patients with T2DM, treatment with SGLT2 inhibitors was associated with a slower decline in kidney function compared with other glucose-lowering drugs.