Did you know...

The link between declining kidney function and mortality in T2DM

  • Over 30% of patients with T2DM have micro or macroalbuminuria.4
  • One of the earliest complications of patients with T2DM is kidney decline. Kidney disease can lead to a 5x increase in mortality rates.4

Kidney disease predominantly accounts for the increased mortality observed in type 2 diabetes4

Invokana gets more patients to target than any other SGLT2i as an add-on-to metformin5-8

58% of patients given Invokana 300mg in addition to metformin achieve the 7% target.7

Not a head-to-head study, figures taken from respective Summary of Product Characteristics.

How Invokana delivers renal benefits

Invokana is an SGLT2 inhibitor, indicated for the treatment of adults with insufficiently controlled T2DM as an adjunct to diet and exercise.7

Improvements in renal outcomes with Invokana are additional benefits only and are not licensed indications.

Find out more about Invokana’s mode of action here

Stabilise eGFR levels for the long term...

Click graph to enlarge

Adapted from Perkovic V et al 20186

  • With standard of care, eGFR declines over time.
  • After an initial fall in mean eGFR after the first 4 weeks of treatment, Invokana stabilises eGFR levels for the long term compared with placebo plus standard of care.9

...and reduce protein in the urine, therefore reducing the risk of Major Adverse Renal Events (MARE)

Patients treated with Invokana were 70% more likely to experience regression of albuminuria, over 6.5 years, compared to standard of care + placebo10

HR: 1.70 (95% CI, 1.51—1.91) Absolute benefit: 105.9 more instances of albuminuria regression per 1000 patient-years.

Invokana showed a 47% relative risk reduction in time to first Major Adverse Renal Event (MARE)2*, over 6.5 years, compared to standard of care + placebo.9

HR: 0.53 (95% CI, 0.33—0.84) ARR: 1.3 fewer MARE per 1000 patient-years.

Invokana - a recommended SGLT2i in the ADA/EASD guidelines

Click diagram to enlarge

Adapted from Davies MJ, D’Alessio DA, Fradkin J et al.
Diabetologia 2018:61:2461

  • The guideline recommends for patients with T2DM where chronic kidney disease (CKD) predominates, an SGLT2i shown to reduce CKD progression is preferable.11
  • If an SGLT2i is not tolerated, or contraindicated, or if eGFR is less than adequate, consider a GLP-1 receptor agonist with proven CVD benefit.11
  • Invokana is a recommended SGLT2 inhibitor at first intensification after metformin.11
Find out more - visit Invokana.co.uk

References

  1. Diabetic nephropathy – kidney disease. Available from: https://www.diabetes.co.uk/diabetes-complications/kidney-disease.html [Accessed August 2019]
  2. Hex N et al. Diabet Med 2012;29:855–62
  3. NEPHRON 2018;139 (suppl1), UK Renal Registry, 20th Annual Report of the Renal Association
  4. Afkarian M, et al. J Am Soc Nephrol 2013;24(2):302-308
  5. Dapagliflozin Summary of Product Characteristics. AstraZeneca. 2018
  6. Empagliflozin Summary of Product Characteristics. Boehringer Ingelheim. 2018
  7. Invokana® Summary of product characteristics. Napp Pharmaceuticals Ltd, 2019
  8. Ertugliflozin Summary of Product Characteristics. Merck Sharp & Dohme. 2019
  9. Perkovic V, et al. The Lancet 2018;(6):691-704
  10. Neal B, et al. N Engl J Med 2017;377(7):644-57
  11. Davies, MJ, D’Alessio DA, Fradkin J et al. Diabetologia 2018:61:2461

Improvements in renal outcomes with Invokana are additional benefits only and not licensed indications.

The starting dose of Invokana is 100mg once daily in patients with an eGFR >60mL/min/1.73m2. Invokana should NOT be initiated in patients with an eGFR of <60mL/min/1.73m2. In patients tolerating Invokana whose eGFR falls persistently below 60mL/min/1.73m2, the dose of Invokana should be adjusted to or maintained at 100mg once daily. Invokana should be discontinued when eGFR is persistently below 45mL/min/1.73m2.