The Scottish Medicines Consortium (SMC) have today confirmed approval for extended access to a medicine called dapagliflozin (with a brand name of Forxiga) for use in some people in Scotland who have chronic kidney disease (CKD).
Dapagliflozin is a sodium-glucose co-transporter-2 (SGLT2) inhibitor. SGLT2 inhibitors are medications that were initially approved for treating type 2 diabetes. They are sometimes called ‘gliflozins’ or ‘flozins’ based on their brand names.
Some SGLT2 inhibitors have been proven to slow the progression of CKD, even in people without diabetes. They work by helping the kidneys to lower blood glucose levels by increasing loss of glucose in the urine.
Kidney Care UK explained to SMC why patients value these medicines
Kidney Care UK contributed to the SMC appraisal of this drug, highlighting the challenges of living with kidney disease and the difference a drug that can slow down progress of the disease and potentially delay the need for dialysis can make to people.
Capturing the views and experiences of patients and carers is an important part of the SMC's appraisal process and plays a key role in helping their committee reach decisions.
This is a significant development for people with early kidney disease in Scotland. Slowing down kidney disease can be life-changing, particularly if it reduces the chances of someone needing dialysis or a kidney transplant. The availability of this treatment provides even more incentive for monitoring people most at risk of CKD, as it enables diagnosis and appropriate treatment as early as possible.Fiona Loud, Policy Director at Kidney Care UK
SGLT2 inhibitors: who are they recommended for?
This medication should be considered for people who are already taking medicines recommended for CKD including angiotensin converting enzyme inhibitors (ACE inhibitors), or angiotensin II receptor blockers (ARBs) unless these are not recommended for the individual), and either, at the start of treatment:
- an estimated glomerular filtration rate (eGFR) of 20 mL/min/1.73m2 up to 45 mL/min/1.73m2, or
- an eGFR of 45 mL/min/1.73m2 up to 90 mL/min/1.73m2 and either:
- A urine albumin-to-creatinine ratio (uACR) of 22.6 mg/mmol or more, or
- Type 2 Diabetes Mellitus (T2DM)
What does SMC’s decision mean for people with CKD in Scotland?
If your healthcare professional thinks that dapagliflozin for use as described above is the right medicine for you, you should be able to have the treatment on the NHS in Scotland.