It seems the usual #EBM suspects are making snarky comments about #CONFIDENCE similar to their comments about #flozins #sglt2i in the years leading up to CREDENCE/DAPA-CKD/EMPA-KIDNEY.
It was obvious then (and it is now) that they don't understand how UACR works as a biomarker

It seems the usual #EBM suspects are making snarky comments about #CONFIDENCE similar to their comments about #flozins #sglt2i in the years leading up to CREDENCE/DAPA-CKD/EMPA-KIDNEY. It was obvious then (and it is now) that they don't understand how UACR works as a biomarker

The results of #confidence were the best news today: combined treatment with #flozin #sglt2i and non steroidal #MRA cut by more than half the level of kidney damage markers (urine albumin/creatinine ratio). In every single trial to date cutting UACR has led to kidney protection

The results of #confidence were the best news today: combined treatment with #flozin #sglt2i and non steroidal #MRA cut by more than half the level of kidney damage markers (urine albumin/creatinine ratio). In every single trial to date cutting UACR has led to kidney protection

The evidence is strong for #SGLT2i and moderate for #GLP1RA (but note that the source data was only designed to infer the effects of the SGLT2i, not the GLP1RA in diabetic kidney disease). Note that combining the 2 drugs has an estimated benefit of .... 3/

Slidedeck from an internal presentation on diabetic kidney disease 👇

Nephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on #Kidney Disease in people with #diabetes #flozin #sglt2i #MRA #GLP1RA
#MedEd #MedMastodon #NephMastodon

https://www.slideshare.net/slideshow/nephrologist-s-take-on-the-effect-and-impact-of-sglt-2-inhibitors-glp-1-ras-and-ns-mra-on-kidney-disease-in-people-with-diabetes/273201765

Slidedeck from an internal presentation on diabetic kidney disease 👇 Nephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on #Kidney Disease in people with #diabetes #flozin #sglt2i #MRA #GLP1RA #MedEd #MedSky #NephSky www.slideshare.net/slideshow/ne...

The take home point from the long term extension of the #sglt2i #flozin EMPA-KIDNEY (#empagliflozin) trial is that the benefit washes VERY SOON after one stops the drug.

A non-proportional hazards analysis would have shown this directly, but it is also evident in the text (contrast the effect size between 6 months & 12 months).

https://www.nejm.org/doi/full/10.1056/NEJMoa2409183

The take home point for clinicians: don't stop the drugs thinking you will get much or a sustained legacy/carryover effect: #sglt2i #flozin drugs have a fast on and a fast off.

x.com

The take home point from the long term extension of the #sglt2i #flozin EMPA-KIDNEY trial is that the benefit washes VERY SOON after one stops the drug. www.nejm.org/doi/full/10.... A non-proportional hazards #stats analysis would have shown it directly, but it is also evident in the text

Long-Term Effects of Empaglifl...

🚨 Big news in ADPKD research!

Two upcoming RCTs on SGLT2i, aiming to extend #SGLT2i benefits to #ADPKD:

🇫🇷 #DAPAPKD, PI @dguerrot & @ecorneclegall: 🎯 Total kidney volume evolution over 2y
🌍 #STOPPKD, PI @MuellerRom, R.Gansevoort, P.Scherrer: 🎯Chronic eGFR slope over 3y

🤝 Pooled analysis of 820 patients planned!

We show here that SGLT2i directly activate pantothenate kinase 1 (#PANK1), the rate-limiting enzyme that initiates the conversion of pantothenate (vitamin #B5) to coenzyme-A (CoA). Using stable-isotope infusion studies, we show that SGLT2i promote pantothenate consumption, activate CoA synthesis, rescue decreased levels of #CoA in human failing hearts, providing a likely explanation for the remarkable clinical benefits of #SGLT2i. https://www.biorxiv.org/content/10.1101/2024.07.26.605401v1

Chronic Kidney Disease in the Older Adult Patient with Diabetes https://www.mdpi.com/2629770
#CKD #Diabetes #FOAMED
Hint: use #flozin #sglt2i #MRA #finerenone #RASi across the age span!

Chronic Kidney Disease in the Older Adult Patient with Diabetes https://www.mdpi.com/2629770 #CKD #Diabetes #FOAMED

Hint: use #flozin #sglt2i #MRA #finerenone #RASi across the age span!

Chronic Kidney Disease in the Older Adult Patient with Diabetes https://www.mdpi.com/2629770

#CKD #Diabetes #FOAMED
Hint: use #flozin #sglt2i #MRA #finerenone #RASi across the age span!

Spokane doctor's breakthrough #kidney disease treatment (that would be an aldosterone synthase inhibitor) shows promising results with #flozins / #SGLT2i
https://www.kxly.com/news/spokane-doctors-breakthrough-kidney-disease-treatment-shows-promising-results/article_d6991e6a-a12a-11ee-967a-1b03c9ea2b60.html?utm_medium=social&utm_source=twitter&utm_campaign=user-share via
See release by #Boehringer https://www.boehringer-ingelheim.com/promising-phase-ii-results-chronic-kidney-disease

Spokane doctor's breakthrough #kidney disease treatment (that would be an aldosterone synthase inhibitor) shows promising results with #flozins / #SGLT2i
https://www.kxly.com/news/spokane-doctors-breakthrough-kidney-disease-treatment-shows-promising-results/article_d6991e6a-a12a-11ee-967a-1b03c9ea2b60.html?utm_medium=social&utm_source=twitter&utm_campaign=user-share via
See release by #Boehringer https://www.boehringer-ingelheim.com/promising-phase-ii-results-chronic-kidney-disease

I guess metformin is looking for new indications as we await the results of the first head-to-head trials against #SGLT2i in #T2D.

https://www.sciencemediacentre.org/expert-reaction-to-study-on-metformin-after-testing-positive-for-sars-cov-2-and-risk-of-developing-long-covid/

I gave my nuanced opinion about #sglt2i in an interview for Nature.
https://www.nature.com/articles/d41586-023-00648-3
#flozination #ChronicKidneyDisease
#diabetes

There will likely be a generic #flozin in the US next year. There are already generic #flozins #sglt2i available in many countries that do not even have the costs used in this simulation, and thus the results don't apply to them. So, while the calculations are likely to become irrelevant in the US very soon, the paper will be used to restrict access to these drugs through formularies in many locales.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2802216?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=030523#.ZATGQTbUGiE.twitter