A multicenter, double-blinded RCT study (386 study sites in 21 countries), that included 270 IgAN patients (254 [94%] confirmed by renal biopsy) with eGFR between 25-75mL/min, and urinary albumin-to-creatinine ratio between 200-5000mg/g. Patients were randomized to receive either dapagliflozin 10mg daily (n=137) or placebo (n=133) as adjunct to standard of care. The primary composite endpoint was sustained decline of eGFR more than or equal to 50%, ESKD, or death due to renal disease- related/cardiovascular cause. The primary outcome was seen in 6 (4%) patients on dapagliflozin and 20 (15%) patients on placebo. Mean rate of eGFR decline was -3.5 and -4.7 mL/min/year with dapagliflozin and placebo respectively. Dapagliflozin reduced uACR was 26% relative to placebo. There were fewer severe adverse events with dapagliflozin. Hence, dapagliflozin reduced the risk of CKD progression in patients with IgANephropathy with good safety profile.
