Charity welcomes potentially life-saving treatment
The National Institute for Health and Care Excellence (NICE), has issued draft guidance recommending a new treatment for patients with chronic kidney disease (CKD) called empagliflozin, which has been shown to slow down progression to kidney failure and reduce the risk of heart attacks and strokes.
Empagliflozin is a type of drug called an SGLT2-inhibitor. NICE is recommending that it is made available to patients who are either at CKD stages 3b-4 (down to 20 ml/min/1.73m2), or are between earlier CKD stages 1-3a and either have a urine albumin to creatine ratio (UACR) of 22.6mg/mmol or have type 2 diabetes. It is to be given to these patients in addition to their other specific treatments (either angiotensin-converting enzyme [ACE] inhibitors or angiotensin receptor blockers).
The news comes two years after dapagliflozin became available to treat CKD – this was the first and is currently the only other SGLT2-inhibitor drug to be recommended by NICE for use in CKD patients. However, empagliflozin is the first SGLT2-inhibitor to become available to CKD patients with severely impaired kidney function without the requirement for them to also have type 2 diabetes or proteinuria.
Important step for kidney emergency
Dr Aisling McMahon, executive director of research and policy at Kidney Research UK said: “This class of drug is one of the best available evidence-based options for tackling kidney disease here and now. We are very pleased to see the range of SGLT2-inhibitors being recommended for patients with chronic kidney disease is broadening.
“In June this year, our report Kidney disease: A public health emergency warned that growing numbers of patients needing dialysis over the next ten years risked overwhelming the NHS unless urgent action was taken. It recommended this class of medication be made more widely available to CKD patients, as part of a package of measures urgently needed to save patients’ lives and prevent more people descending into kidney failure and requiring dialysis. The approval of empagliflozin for patients in England and Wales would be an important step in the right direction.”
What is empagliflozin?
Empagliflozin has been used for some years to treat high blood sugar in people with diabetes. Regular high blood sugar and sodium levels can both result in permanent damage to the cardiovascular system and the kidneys. Empagliflozin prevents excess blood sugar being reabsorbed into the bloodstream through the kidneys, enabling it to pass into the urine and it may also increase the amount of sodium that is excreted too.
What the NICE recommendation means for kidney patients
A recent trial called EMPA-KIDNEY clearly showed that empagliflozin lowered the risk of kidney disease progressing and of death from cardiovascular causes in kidney patients by 28 per cent. The risk of hospitalisation for any cause was also 14% lower in patients treated empagliflozin. This means the NICE recommendation is good news for kidney patients in England and Wales who fit the criteria. Decisions in Scotland are expected to follow.
Patients and their GPs can check the criteria on the NICE website to see if empagliflozin is right for their particular circumstances.