Why carry out this study?

End-stage kidney disease (ESKD) commonly results from diabetes and leads to dialysis, which has substantial impacts on patients’ quality and quantity of life and health care spending.

Canagliflozin, a sodium glucose co-transporter 2 inhibitor indicated for type 2 diabetes mellitus, was shown to reduce the risk of ESKD by 32% and slow the rate of estimated glomerular filtration rate (eGFR) decline by 60% in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial.

This analysis estimated the delay in time to dialysis and the economic value of delaying dialysis in patients treated with canagliflozin using linear projections of eGFR slope from the CREDENCE trial.

What was learned from the study?

For patients with diabetic nephropathy who are similar to CREDENCE trial participants, canagliflozin was projected to delay the initiation of dialysis by 12.95 years relative to placebo, with an estimated cost savings of approximately $170,000 per patient treated with canagliflozin.

The use of eGFR slopes from clinical trial data allowed straightforward estimation of important health care outcomes, indicating a substantial delay in the need for dialysis and reduction in costs in a population of patients treated with canagliflozin based on the CREDENCE study.

These findings support further analysis using disease models that consider nonlinear eGFR slopes, competing risk factors, and varying baseline patient characteristics.