NICE guidance - empagliflozin for treating chronic kidney disease
NICE states:
Empagliflozin is recommended as an option for treating chronic kidney disease (CKD) in adults, only if:
- it is an add-on to optimised standard care, including the highest tolerated licensed dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), unless these are contraindicated, and
- people have an estimated glomerular filtration rate of:
- 20 ml/min/1.73 m2 to less than 45 ml/min/1.73 m2 or
- 45 ml/min/1.73 m2 to 90 ml/min/1.73 m2 and either:
- a urine albumin-to-creatinine ratio of 22.6 mg/mmol or more, or
- type 2 diabetes
The NICE committee noted:
- clinical trial evidence suggests that empagliflozin plus standard care is more effective than standard care alone
- there are no clinical trials directly comparing empagliflozin with dapagliflozin in people with CKD
- results of an indirect comparison suggest that empagliflozin has a similar effectiveness to dapagliflozin, and it likely has similar safety
- CKD can progress more quickly in some ethnic minority groups, and, in people with type 2 diabetes, it progresses more quickly in people under 55
- was acknowledged but could not be considered in the decision-making
Reference:
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