medwireNews: A post-hoc analysis of DAPA-CKD indicates that people taking dapagliflozin have a reduced risk for hospitalization, for causes not limited to cardiac or renal.
“Hospitalization contributes to the burden of CKD [chronic kidney disease] and reduces health-related quality of life,” as well as being very expensive, say Hiddo Heerspink (University of Groningen, the Netherlands) and study co-authors.
“A reduction in hospitalization of even half the magnitude of what was reported in the DAPA-CKD trial would be expected to significantly reduce health care expenditures in the United States and elsewhere,” they add.
During the median 2.4 years of follow-up, there were a total of 2072 hospitalizations for any reason, affecting 1224 (28.4%) of the 4304 trial participants. More than half (59.1%) of the hospitalizations were “prolonged or ended in death,” note the researchers in the Annals of Internal Medicine.
The event rate for any hospitalization was 143.7 per 1000 person–years among people taking dapagliflozin versus 171.9 per 1000 person–years in the placebo group, giving a significant 16% reduced risk favoring dapagliflozin. There was also a significant 17% reduction in the risk for a hospitalization that was prolonged or ended in death.
These benefits occurred irrespective of people’s baseline estimated glomerular filtration rate (eGFR) and whether or not they had type 2 diabetes.
Taking dapagliflozin reduced the risk for hospitalization for cardiac causes by a significant 33% and for renal and urinary disorders by 39%.
But there were also significant reductions in the risk for hospitalization with neoplasms, by 38%, and metabolism and nutrition disorders, by 39%, with the latter comprising electrolyte, glucose, and acid–base disturbances, which the team says are common in people with CKD.
There were no significant differences in the risk for hospitalizations for infections and infestations, nervous system disorders, gastrointestinal disorders, injury and poisoning, or vascular disorders, or for respiratory, thoracic, and mediastinal disorders.
“These findings highlight additional benefits of dapagliflozin beyond those seen for cardiovascular and kidney events, all-cause and cause-specific mortality, eGFR slope, and albuminuria and should be considered when evaluating the totality of evidence favoring provision of dapagliflozin to patients with CKD,” the researchers conclude.
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Ann Intern Med 2022; doi:10.7326/M22-2115