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cross section of human kidneys

A new analysis of data collected by the EMPA-KIDNEY trial has demonstrated that people living with chronic kidney disease (CKD) continue to see benefits from empagliflozin for up to one year after stopping treatment with a 13% lower risk of kidney disease progression. The results were announced today at the American Society of Nephrology’s Kidney Week conference and published in the New England Journal of Medicine.

Chronic kidney disease (CKD) is often a progressive condition that can lead to the need for kidney dialysis or a transplant and increases the risk of cardiovascular disease. It affects an estimated 1 in 10 people worldwide and is a leading cause of death globally. In November 2022, the EMPA-KIDNEY trial demonstrated that empagliflozin, a treatment originally developed for diabetes, could reduce the risk of kidney disease progression or cardiovascular death (death as a result of heart disease or a heart attack) by up to 28% in people living with CKD.

In this new post-trial follow up analysis, researchers looked at the health records for 4,891 of the original 6,609 participants for two years after the trial had ended to see whether the treatment continued to work after the participants stopped taking it and for how long they could expect to benefit from it.

Key findings:

  • Empagliflozin reduced the risk of kidney disease progression or cardiovascular death by 13% in the post-trial follow up period;
  • Participants saw the most benefit from the treatment in the first six months after treatment had stopped and this effect was shown to last until up to 12 months after the trial had ended;
  • Empagliflozin reduced the risk of death from cardiovascular causes, but did not have any effect on the risk of death from other causes.

Will Herrington, Professor of Trials and Epidemiology of Kidney Disease at Oxford Population Health, and co-Principal Investigator of the trial, said ‘EMPA-KIDNEY has already shown that taking empagliflozin over two years safely reduced the risk of kidney disease progression or cardiovascular death by 28%. The trial participants have now been observed for two additional years, revealing important insights into the remaining benefits of empagliflozin after the participants stopped taking it. The results of the post-trial follow up have given us key evidence that, while empagliflozin continues to have some benefit after stopping treatment, the effects are smaller than when taking empagliflozin and short lived. Maximising the benefits of such medicines in chronic kidney disease requires long-term treatment.’

Treatments such as empagliflozin, known as sodium-glucose cotransporter-2 (SGLT2) inhibitors, or “flozins”, reduce blood sugar levels by helping the kidneys to pass excess sugar out of the body in urine. They were originally developed to treat diabetes, and were subsequently shown to benefit patients with CKD. The EMPA-KIDNEY trial demonstrated that empagliflozin benefits CKD patients without diabetes and others at risk of kidney disease progression, as well as those with diabetes.

The EMPA-KIDNEY trial was initiated, designed and conducted by scientists at Oxford Population Health’s Renal Studies Group in collaboration with a Steering Committee and 241 hospitals or clinics in eight countries who adopted our streamlined methods to randomise large numbers of patients and answer an important clinical question definitively. It was supported by funding from Boehringer Ingelheim and Eli Lilly and Company.