The following is a summary of “Sodium-Glucose Cotransporter-2 Inhibitor and Glucagon-Like Peptide-1 Receptor Agonist Discontinuation in Patients with CKD,” published in the August 2024 issue of Nephrology by Parker et al.
There is limited information on how stopping sodium-glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists affects patients with chronic kidney disease (CKD).
Researchers conducted a retrospective study understanding the impact of discontinuing SGLT2 inhibitors and GLP-1 receptors on CKD outcomes.
They studied adults with CKD stages 3-4 between 2005-2022 registered in the Veterans Affairs healthcare system. Patients with SGLT2 inhibitors or GLP-1 RAs as incident prescriptions were tracked for the study. Factors involved with treatment discontinuation for ≥90 days, 90-179 days, and ≥180 days were studied, and their impact on health outcomes was analyzed using Cox proportional hazards regression models.
The results showed that among 96,345 SGLT2 inhibitors users and 60,020 GLP-1 RA users, 37% (n=35,953) and 47% (n=28,407) had at least one discontinuation, respectively. It stated that SGLT2 inhibitor users were 24% Black, 71% White, 71% aged 70 or older, and 84% with CKD stage 3a. GLP-1 RA users were 20% Black, 75% White, 63% aged 70 or older, and 81% with CKD stage 3a. Discontinuation was linked to Black race, Hispanic ethnicity, and several health conditions. Discontinuation of SGLT2 inhibitors for ≥180 days increased the risk of death (HR 1.67 [95% CI: 1.58-1.77]) and heart failure hospitalization (HR 1.26 [1.13-1.40]). Discontinuation of GLP-1 RAs for ≥180 days increased the risk of death (HR 1.97 [1.87-2.07]), myocardial infarction (HR 1.23 [1.11-1.36]), heart failure hospitalization (HR 1.48 [1.33-1.64]), and ischemic stroke (HR 1.24 [1.14-1.35]).
Investigators concluded that stopping SGLT2 inhibitors and GLP-1 RAs was common among adults with CKD and linked to adverse health outcomes.
Source: journals.lww.com/jasn/abstract/9900/sodium_glucose_cotransporter_2_inhibitor_and.405.aspx
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