Empagliflozin Improves Urinary Albumin Excretion in Patients With Type 2 Diabetes

August 5, 2017. The effect of empagliflozin, a sodium-glucose cotransporter 2 (SGLT-2) inhibitor, on urinary albumin-to-creatinine ratio (UACR) was explored in an analysis of data from EMPA-REG OUTCOME, a randomized, placebo-controlled trial. In the exploratory analysis, 6,953 patients were stratified according to albuminuria status at baseline (normo-, micro-, or macroalbuminuria) and data were pooled for the empagliflozin arms (10 and 25 mg) vs placebo. UACR levels were assessed at 12 and 164 weeks. Analysis revealed that patients in the empagliflozin arms were more likely than those in the placebo arm to experience a sustained improvement over time from microalbuminuria to normoalbuminuria (hazard ratio [HR] 1.43, 95% CI: 1.22-1.67; P<0.0001). The same pattern held for sustained improvements from macroalbuminuria to microalbuminuria or normoalbuminuria (HR 1.82, 1.40-2.37; P<0.0001). The likelihood of experiencing a sustained deterioration from normoalbuminuria to microalbuminuria or macroalbuminuria was also reduced in the empagliflozin arms (HR 0.84, 0.74-0.95; P=0.0077). Adverse events were similar between treatment groups, except for genital infections which were more common in patients in the empagliflozin arm. Read the study abstract here.