Cardiovascular Diabetology (Nov 2023)

Effects of dapagliflozin and dapagliflozin-saxagliptin on erythropoiesis, iron and inflammation markers in patients with type 2 diabetes and chronic kidney disease: data from the DELIGHT trial

  • Akihiko Koshino,
  • Brendon L. Neuen,
  • Niels Jongs,
  • Carol Pollock,
  • Peter J. Greasley,
  • Eva-Marie Andersson,
  • Ann Hammarstedt,
  • Cecilia Karlsson,
  • Anna Maria Langkilde,
  • Takashi Wada,
  • Hiddo J.L. Heerspink

DOI
https://doi.org/10.1186/s12933-023-02027-8
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 7

Abstract

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Abstract Background This post-hoc analysis of the DELIGHT trial assessed effects of the SGLT2 inhibitor dapagliflozin on iron metabolism and markers of inflammation. Methods Patients with type 2 diabetes and albuminuria were randomized to dapagliflozin, dapagliflozin and saxagliptin, or placebo. We measured hemoglobin, iron markers (serum iron, transferrin saturation, and ferritin), plasma erythropoietin, and inflammatory markers (urinary MCP-1 and urinary/serum IL-6) at baseline and week 24. Results 360/461 (78.1%) participants had available biosamples. Dapagliflozin and dapagliflozin-saxagliptin, compared to placebo, increased hemoglobin by 5.7 g/L (95%CI 4.0, 7.3; p < 0.001) and 4.4 g/L (2.7, 6.0; p < 0.001) and reduced ferritin by 18.6% (8.7, 27.5; p < 0.001) and 18.4% (8.7, 27.1; p < 0.001), respectively. Dapagliflozin reduced urinary MCP-1/Cr by 29.0% (14.6, 41.0; p < 0.001) and urinary IL-6/Cr by 26.6% (9.1, 40.7; p = 0.005) with no changes in other markers. Conclusions Dapagliflozin increased hemoglobin and reduced ferritin and urinary markers of inflammation, suggesting potentially important effects on iron metabolism and inflammation. Trial registration ClinicalTrials.gov NCT02547935.

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