Dr Tae Won Yi1,2, MOHAMMAD ATIQUZZAMAN3, YUYAN ZHENG3, BRENDAN SMYTH2,4, MEG JARDINE2,5, ADEERA LEVIN3,6
1The George Institute for Global Health, University of New South Wales, Sydney, Australia, 2NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia, 3BC Provincial Renal Agency, Vancouver, Canada, 4Department of Renal Medicine, St George Hospital, Kogarah, Australia, 5Department of Nephrology, Concord Repatriation General Hospital, Sydney, Australia, 6Division of Nephrology, University of British Columbia, Vancouver, Canada
Aim: Using a chronic kidney disease (CKD) population database of those in nephrology care in British Columbia (BC), Canada, we aimed to determine how many patients would qualify for CREDENCE and DAPA-CKD trials, to compare the number of events with the placebo arms of the trials, and to calculate a cost-avoidance analysis from dialysis prevention using sodium-glucose cotransporter-2 inhibitors (SGLT2i) in the cohort.
Background: CREDENCE and DAPA-CKD trials demonstrated significant benefits with SGLT2i, decreasing the rates of kidney and cardiovascular events in comparison to placebo.
Methods: The BC cohort was derived by combining the eligibility criteria from both CREDENCE and DAPA-CKD to generate a comprehensive cohort like that of the trials. The inclusion criteria were: ≥18 years with a UACR ≥20mg/mmol and an eGFR between 25-90mL/min/1.73m2 between April 1st 2014 to March 31st 2017. The composite outcome of doubling of serum creatinine and end stage kidney disease in the BC cohort was compared to the placebo arms of CREDENCE and DAPA-CKD.
Results: A total of 3,138 out of 17,963 (17.5%) of CKD patients were eligible. The event rate of end stage kidney disease and death was 3 times greater in the BC cohort than the placebo arms of the published studies. When stratified by eGFR categories, event rates were similar in the <45 mL/min/1.73m2 groups between the BC cohort and CREDENCE. BC cohort experienced higher events rates in the >45 mL/min/1.73m2 groups. Cost-avoidance analysis demonstrated the potential to save 2.3-8.2 million with widespread use of SGLT2i in the BC cohort.
Conclusions: The use of SGLT2i may improve outcomes and reduce health care system costs in a nephrology referral population.
Biography:
Bio to come