Efficiency of empagliflosin in combined nephroprotective therapy in patients with type 2 diabetes mellitus

Abstract

INTRODUCTION. The data obtained in clinical studies of recent years of the possible inhibitors of sodium-glucose cotransporter type 2 (SGLT2) nephroprotective effect in type 2 diabetes mellitus necessitate the further study of these drug's effect on kidney injury risk factors.THE AIM: to study the effect of SGLT2 inhibitor empagliflozin as part of combination therapy on the main mechanisms of kidney damage in patients with type 2 diabetes.PATIENTS AND METHODS. We have completed a clinical randomized study in parallel groups in patients with type 2 diabetes of nephroprotective effects of SGLT2 inhibitor empagliflozin during 2 years. The study included 244 patients with type 2 diabetes with a preserved glomerular filtration rate (GFR) and moderate arterial hypertension (AH), who had previously taken perindopril and indapamide, but did not reach target blood pressure (BP) values. Patients were randomized into 2 groups: Group I (n = 120) took Perindopril 10 mg per day, Indapamide retard 1.5 mg per day, β-blocker Carvedilol 12.5-25 mg 2 times a day; Group II (n = 124) was additionally prescribed empagliflozin 25 mg per day. The study endpoints were GFR changes, albuminuria, and renal blood flow as measured by Doppler imaging. Also studied the dynamics of blood pressure and glycemic control.RESULTS. It was found that empagliflozin as part of complex therapy for type 2 diabetes is able to reduce albuminuria and prevent a decrease in GFR within a 2-year follow-up period. The use of empagliflozin promoted an increase in the rate of renal blood flow and a decrease in intrarenal vascular resistance and had a corrective effect on the daily dynamics of blood pressure and glycemic control.CONCLUSION. Empagliflozin improves intrarenal and systemic hemodynamics, prevents a decrease in GFR, reduces albuminuria, and improves glycemic control in type 2 diabetes.