Sodium–glucose cotransporter 2 (SGLT2) inhibitors are recommended agents for the treatment of diabetic kidney disease (DKD). Additionally, SGLT2 inhibitors lower blood glucose, decrease blood pressure, and can be useful for volume management. For these reasons, we hypothesized that initiating SGLT2 inhibitor therapy may be associated with deprescribing of other medications in patients with DKD. We compared medication lists at SGLT2 inhibitor initiation and 6 months post-initiation in 21 patients with DKD who were followed in our interprofessional outpatient nephrology clinic to evaluate deprescribing patterns in diabetes, hypertension, and diuretic medications. Six months of SGLT2 inhibitor therapy in patients with DKD was associated with deprescribing of high-risk diabetes agents, antihypertensives, and loop diuretics with minimal changes in A1C and fewer adverse events.
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Spring 2022
Feature Articles|
April 15 2022
Medication Optimization for New Initiators of Empagliflozin for Diabetic Kidney Disease
Andrew A. Swanner;
Andrew A. Swanner
1Pharmacy Department, VA Boston Healthcare System, Boston
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Chelsea E. Hawley;
Chelsea E. Hawley
2New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston
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Kay Li;
Kay Li
1Pharmacy Department, VA Boston Healthcare System, Boston
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Laura K. Triantafylidis
;
Laura K. Triantafylidis
1Pharmacy Department, VA Boston Healthcare System, Boston
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Jiahua Li;
Jiahua Li
3Renal Section, VA Boston Healthcare System, Boston
4Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
5Harvard Medical School, Boston, MA
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Julie M. Paik
2New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston
3Renal Section, VA Boston Healthcare System, Boston
4Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
5Harvard Medical School, Boston, MA
6Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
Corresponding author: Julie M. Paik, julie.paik@va.gov
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Corresponding author: Julie M. Paik, julie.paik@va.gov
Clin Diabetes 2022;40(2):158–167
Citation
Andrew A. Swanner, Chelsea E. Hawley, Kay Li, Laura K. Triantafylidis, Jiahua Li, Julie M. Paik; Medication Optimization for New Initiators of Empagliflozin for Diabetic Kidney Disease. Clin Diabetes 1 April 2022; 40 (2): 158–167. https://doi.org/10.2337/cd21-0078
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