Empagliflozin continues to demonstrate significant cardiorenal benefits in patients with chronic kidney disease (CKD), with post-trial follow-up (PTFU) data from the phase 3 EMPA-KIDNEY trial indicating sustained positive outcomes for approximately one year after discontinuation of the drug. The findings, presented at the American Society of Nephrology (ASN) Kidney Week 2024, highlight the long-term impact of empagliflozin on kidney function and cardiovascular health.
Sustained Benefits Post-Treatment
Will Herrington, Professor of Trials and Epidemiology of Kidney Disease at Oxford University, presented the PTFU data, noting the unexpected carryover effect of empagliflozin. The study revealed that kidney disease progression or cardiovascular death occurred in 26.2% (865/3305) of participants who received empagliflozin, compared to 30.3% (1001/3305) in the placebo group, demonstrating a hazard ratio (HR) of 0.79 [95% CI, 0.72-0.87] over the entire follow-up period. Notably, even after discontinuation, participants initially treated with empagliflozin experienced a 13% reduction (HR, 0.87 [95% CI, 0.76-0.99]) in the risk of kidney disease progression or cardiovascular death.
Clinical Implications and Adherence
Herrington emphasized the clinical significance of these findings, stating, "The corollary of all of this means that the drug is safe. The drug works, it will continue to work for about a year after you stop taking it. But if you stop taking it for more than a year, then you lose all of the benefits... We should be ensuring our patients stay on the drug at the at the full dose long term to ensure we maximize their benefits."
The results underscore the importance of long-term adherence to empagliflozin to maintain its protective effects on kidney function and cardiovascular outcomes in patients with CKD. The study suggests that while empagliflozin provides a sustained benefit even after discontinuation, the benefits diminish after approximately one year, reinforcing the need for continuous treatment to maximize patient outcomes.
