DAPA-CKD Trial
Why was the trial stopped early?
What is the patient type for Farxiga's new CKD indication?
Patient with eGFR<60 and T2D
I am going to use Jardiance because this is a class effect and Jardiance is better covered.
No! There is simply not enough data at this point to say this is a class effect. Please follow evidence based medicine.
OR...they do not have this indication and in their label it warns not to use in patients who show an EGFR consistently below 45.
Describe the safety of Farxiga.
Expansive, established safety profile!
How many patients in the trial?
4304
What is the NNT for the primary composite endpoint in DAPA CKD?
19
I just don't buy into this...no guidelines are telling me to do this.
Sell unmet need!
What is the eGFR range in the DAPA CKD trial?
25-75
How many patients were on the standard of care (ACEs/ARBs)?
97%
Describe the legacy of Farxiga and the landmark trials
Farxiga has expanded beyond patients with T2D.
2013: Glycemic control
2019: Declare
2020: DAPA-HF
2021: DAPA-CKD
I was under the impression SGLT2 inhibitors could harm the kidney. How am I now hearing they could benefit the kidney?
The renal safety of Farxiga has been assesses in more than 30,000 patients in 3 different disease states, including patients with eGFRs as low as 25. So we now know more about the effects of Farxiga on the kidney.
Describe the severe hypoglycemic events or DKA in the DAPA-CKD trial.
No occurrences of severe hypoglycemic events or DKA were observed in patients with out without T2D.
How many patients had T2D?
68%
What is the unmet need?
There has been no therapies approved in over 20 years to help delay the worsening of CKD in patients at risk of progression with and without T2D.
You have data in patients with and without T2D. Why are you asking me to prescribe for a patient with T2D?
- For many patients with T2D their PCP is the Dr they see most often and who is integral in making treatment decisions.
- T2D is a significant risk factor for renal impairment.
- Up to 40% of adults with T2D will develop CKD.
- Once kidney function is lost, it is rarely recovered. So now for this reason, consider RXing Farxiga for your patients with T2D to help protect against worsening kidney function, dialysis, and CV or renal death, so that they can live life.
What is the new indication for Farxiga?
Reduce the risk of sustained eGFR decline, end-stage kidney disease, CV death and hospitalization for heart failure in adults with CKD at risk of progression.
What is the RRR of all-cause mortality?
31%
What does a 30 second detail look like for Farxiga's CKD indication?
(observe for patient type, efficacy, safety, check-in for alignment, close for accountability)
I am confused, how does Farxiga actually work for heart failure and CKD?
- Farxiga compliments ACE/ARB therapy to help provide additional kidney protection.
- It reduces sodium reabsorption and increases the delivery of sodium to the distal tubule. This may drive a feedback mechanism in the kidney, which decreases intraglomerular pressure.
- Farxiga lowers intraglomerular pressure by increasing afferent arteriolar vasoconstriction.
- ACEs/ARBs lowers intraglomerular pressure by increasing efferent arteriolar vasodilation.
Describe the dosing and how to start patients on Farxiga
- Starting dose is 10 mg once daily no titration
- Initiated for patients with eGFR as low as 25.
- Treatment with Farxiga can be continued up to the start of dialysis to reduce the risk of eGFR decline, ESKD, or CV death
- Contraindicated in patients on dialysis.