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A two-year post-trial follow-up study of the EMPA-KIDNEY trial demonstrates that empagliflozin therapy provides sustained cardiorenal benefits in chronic kidney disease (CKD) patients, with effects persisting for approximately 12 months after discontinuation. The study, presented at Kidney Week 2024, evaluated 4,895 patients and revealed important insights about the long-term efficacy of SGLT2 inhibitor treatment in CKD management.
Key Points:
- The original EMPA-KIDNEY trial included 6,609 CKD patients stratified by eGFR (20 to <45 mL/min/1.73 m² or 45 to <90 mL/min/1.73 m² plus ACR ≥200 mg/g), with participants receiving empagliflozin for a median of 2 years.
- Post-trial SGLT2 inhibitor use was similar between groups (43% empagliflozin group vs. 40% placebo group), enabling researchers to assess carry-over effects from the initial treatment period.
- Empagliflozin reduced the primary outcome of cardiovascular death or kidney disease progression (26.2% vs. 30.3% in placebo; HR 0.79; 95% CI 0.72-0.87), demonstrating a 13% risk reduction during follow-up.
- First-year post-trial outcomes showed continued benefit (5.7% vs. 7.1%; HR 0.76; 95% CI 0.60-0.96), while second-year results showed diminishing effects (12.7% vs. 13.6%; HR 0.9; 95% CI 0.75-1.07).
- Relative effects remained consistent across key subgroups, including patients with diabetes and varying levels of eGFR and urine ACR.
“Any post-trial benefits appeared to last for only about 12 months, so maximizing cardiorenal benefits of SGLT2 inhibitors in chronic kidney disease requires long-term treatment.”
– Dr. William G. Herrington, University of Oxford, Oxford, Oxfordshire, United Kingdom
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