MONDAY, April 15, 2019 — A common diabetes drug may also greatly reduce the odds for death from kidney failure and heart disease in diabetes patients with kidney disease, a new study finds.
The news on Invokana (canagliflozin) is important, experts say, because diabetes and kidney trouble so often go together.
“Diabetes is the leading cause of kidney failure worldwide, but for almost two decades there have been no new treatments to protect kidney function,” noted study lead author Vlado Perkovic. He’s a professor at The George Institute for Global Health at Oxford University in the United Kingdom.
“This definitive trial result is a major medical breakthrough as people with diabetes and kidney disease are at extremely high risk of kidney failure, heart attack, stroke and death,” Perkovic said in a university news release. “We now have a very effective way to reduce this risk using a once daily pill.”
The research was paid for by drug company Janssen, which makes Invokana. The study involved more than 4,400 patients with diabetes and kidney disease across 34 countries. Half took Invokana and half took a “dummy” placebo pill. All of them received care for kidney disease according to current guidelines.
Those who took Invokana had a 30% lower risk of developing kidney failure, a 30% lower risk of dying from kidney failure or heart disease, a 20% lower risk of major heart events such as heart attack, stroke, or heart-related death, and a 39% lower risk of hospitalization for heart failure, the researchers reported.
The findings were published April 15 in the New England Journal of Medicine.
There was no higher risk of major side effects among those who took Invokana, according to the study, which was also due to be presented Monday at the ISN World Congress of Nephrology, in Melbourne, Australia.
Invokana is from a class of diabetes medicines known as sodium glucose transporter 2 (SGLT2) inhibitors.
Study co-author Meg Jardine, associate professor at The George Institute, said, “With 5 million people worldwide predicted to have kidney failure by 2035, this is a major breakthrough.”
Two experts in diabetes and renal (kidney) care who read over the new study agreed the findings are significant.
“Upwards of 40% of end-stage renal disease patients have diabetes as the cause of their renal failure,” noted Dr. Maria DeVita, chief of nephrology at Lenox Hill Hospital in New York City.
She explained that SGLT2 inhibitor medicines like Invokana work by blocking the “reuptake” of glucose within the kidney. More of this blood sugar, as well as salt, are therefore excreted harmlessly in urine instead of lingering in the kidneys where they can do damage, DeVita said.
So, Invokana “may substantially change the trajectory of kidney decline, preserving kidney function for years longer than we thought possible for the long term,” DeVita said. “This is wonderful news for those with diabetic kidney disease.”
Dr. Guy Mintz directs cardiovascular health at the Sandra Atlas Bass Heart Hospital in Manhasset, N.Y. He also believes the new findings are “exciting.”
“With another impressive study of this family of medications, SGLT2 inhibitors should now be utilized in all type 2 diabetic patients with kidney disease and increased cardiovascular risk,” as long as there are no reasons not to do so, Mintz believes.
“This is another tool in our belt to reduce progressive kidney disease and cardiac events in our type 2 diabetic population with kidney disease,” he said.