Diabetes drug protects against kidney disease

A drug developed to help people with diabetes has been found to reduce heart failure, major cardiovascular events and protect against kidney failure.

Researchers presenting the results of their study into the drug canagliflozin at the ISN World Congress of Nephrology in Melbourne last night.

Because the drug is already available, it could be deployed widely and rapidly, the researchers say.

Lead author Professor Vlado Perkovic, of The George Institute for Global Health, which is affiliated to Oxford University, UK, as well as universities in Australia and China, said: “Diabetes is the leading cause of kidney failure worldwide but for almost two decades there have been no new treatments to protect kidney function.

“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. We now have a very effective way to reduce this risk using a once daily pill.”

The study involved 4,401 patients with diabetes and kidney disease from 34 countries. Half were given canagliflozin on top of either angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), while the control group received best available care, and a placebo.

Of those who took canagliflozin, which is a sodium glucose transporter 2 (SGLT2) inhibitor, the number of people developing kidney failure or dying from either kidney failure or cardiovascular disease fell by 30%, while incidents of hospitalisation for heart failure reduced by 39%.

The risk of heart attack, stroke and cardiovascular death fell by 20% and there was no increased risk of major side effects.

Co-author Associate Professor Meg Jardine, of The George Institute, said: “What we have shown is that this drug not only protects people with diabetes from developing kidney failure, but it also protects them from heart disease, heart failure and other cardiovascular complications. Importantly, it helps people who already have reduced kidney function and are at particularly high risk.”

Professor Perkovic described the results as “impressive”, adding: “The substantial benefit on kidney failure despite limited effects on blood glucose suggest that these drugs work in a number of different ways beyond their effects on blood sugar. This is an area of intense ongoing research.”