From the Guidelines
Farxiga (dapagliflozin) is recommended for chronic kidney disease (CKD) patients with an eGFR of 25-75 mL/min/1.73m² and albuminuria (UACR ≥200 mg/g), regardless of diabetes status. The standard dose is 10 mg once daily, taken in the morning with or without food. Farxiga works by inhibiting SGLT2 in the kidneys, reducing glucose reabsorption and increasing glucose excretion in urine. Beyond glucose control, it provides kidney protection by reducing intraglomerular pressure, decreasing hyperfiltration, and offering anti-inflammatory effects. Clinical trials have shown Farxiga reduces the risk of kidney function decline, end-stage kidney disease, and cardiovascular death in CKD patients, as demonstrated in the DAPA-CKD study 1. Common side effects include genital yeast infections and urinary tract infections. Patients should be monitored for volume depletion, especially when starting treatment. Farxiga should not be initiated in patients with eGFR below 25 mL/min/1.73m² and is contraindicated in patients on dialysis or with a history of serious hypersensitivity reactions to the medication. Key benefits of Farxiga include:
- Reduced risk of kidney function decline
- Reduced risk of end-stage kidney disease
- Reduced risk of cardiovascular death
- Kidney protection through reduced intraglomerular pressure and hyperfiltration
- Anti-inflammatory effects It is essential to consider the patient's individual needs and medical history when prescribing Farxiga, as well as to monitor for potential side effects and adjust treatment accordingly, as recommended by recent guidelines 1.
From the FDA Drug Label
Dapagliflozin reduced the incidence of the primary composite endpoint of ≥50% sustained decline in eGFR, progression to ESKD, CV or renal death [HR 0.61 (95% CI 0.51,0.72); p<0. 0001]. DAPAGLIFLOZIN TABLETS are a prescription medicine used: ∘ to reduce the risk of further worsening of your kidney disease, end-stage kidney disease (ESKD), death due to cardiovascular disease, and hospitalization for heart failure in adults with chronic kidney disease
Farxiga (dapagliflozin) is used to reduce the risk of worsening kidney disease, end-stage kidney disease, and cardiovascular death in adults with chronic kidney disease (CKD).
- The medication has been shown to reduce the incidence of ≥50% sustained decline in eGFR, progression to ESKD, CV or renal death in patients with CKD.
- It is also used to reduce the risk of hospitalization for heart failure in adults with CKD.
- The treatment effect reflected a reduction in ≥50% sustained decline in eGFR, progression to ESKD, and CV death 2.
From the Research
Farxiga for CKD
- Farxiga (dapagliflozin) is approved to reduce the risk of declining kidney function, kidney failure, cardiovascular death, and hospitalization for heart failure in adults with chronic kidney disease (CKD) with or without type 2 diabetes 3.
- The DAPA-CKD trial showed that dapagliflozin significantly reduced albuminuria in patients with CKD with and without type 2 diabetes, with a larger relative reduction in patients with type 2 diabetes 4.
- Dapagliflozin has been shown to be effective in slowing CKD progression in patients with higher levels of albuminuria, and its real-world effectiveness has been evaluated among patients with CKD with lower levels of albuminuria 5.
- An acute reduction in eGFR upon initiation of dapagliflozin is not associated with higher rates of CKD progression, and patients who experienced an acute reduction in eGFR >10% had a slower long-term eGFR decline compared to those with a less pronounced reduction or increase in eGFR 6.
Key Findings
- Dapagliflozin reduces the risk of kidney disease progression and cardiovascular events in patients with CKD 3, 4.
- The drug is effective in reducing albuminuria in patients with CKD with and without type 2 diabetes 4.
- Dapagliflozin has been shown to be effective in patients with CKD with lower levels of albuminuria, with a clinically meaningful attenuation of eGFR slope compared to non-initiation 5.
- An acute reduction in eGFR upon initiation of dapagliflozin is a reversible and harmless effect, and is not associated with higher rates of CKD progression 6.