{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:11:27Z","timestamp":1790957487904,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T00:00:00Z","timestamp":1691971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["917.15.306"],"award-info":[{"award-number":["917.15.306"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To estimate the lifetime benefit of a combination treatment of sodium\u2010glucose co\u2010transporter 2 (SGLT2) inhibitors and mineralocorticoid\u2010receptor antagonists (MRA) in patients with type 2 diabetes and chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>The cumulative effect of combination treatment was derived from trial\u2010level estimates of the effect of an SGLT2 inhibitor (canagliflozin) and MRA (finerenone) from the CREDENCE (N\u2009=\u20094401) and FIDELIO (N\u2009=\u20095734) trials, respectively. The cumulative effect was applied to the control group of patients with type 2 diabetes in the DAPA\u2010CKD trial (N\u2009=\u20091451) to estimate long\u2010term gains in event\u2010free and overall survival. The analysis was repeated in an observational study. The primary outcome was a composite endpoint of doubling of serum creatinine, end\u2010stage kidney disease or death because of kidney failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The hazard ratio of combination treatment for the primary outcome was 0.50 [95% confidence interval (CI): 0.44, 0.57]. At age 50\u2009years, the estimated event\u2010free survival from the primary outcome was 16.7\u2009years (95% CI: 18.1, 21.0) with combination treatment versus 10.0\u2009years (95% CI: 6.8, 12.3) with angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers resulting in an incremental gain of 6.7\u2009years (95% CI: 5.5, 7.9). In an observational study, the estimated gain in event\u2010free survival regarding primary outcome was 6.3\u2009years (95% CI: 5.2, 7.3). In a conservative scenario, assuming low adherence (70% of the observed adherence) and less pronounced efficacy (70% of the observed efficacy with 2% yearly decline) of combination therapy, gain in event\u2010free survival regarding primary outcome was 2.5\u2009years (95% CI: 2.0, 2.9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined disease\u2010modifying treatment with an SGLT2 inhibitor and MRA in patients with type 2 diabetes and CKD may substantially increase the number of years free from kidney failure and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15232","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T22:48:01Z","timestamp":1692053281000},"page":"3327-3336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Estimated lifetime benefit of novel pharmacological therapies in patients with type 2 diabetes and chronic kidney disease: A joint analysis of randomized controlled clinical trials"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-3730","authenticated-orcid":false,"given":"Hiddo J. L.","family":"Heerspink","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University of Groningen University Medical Center Groningen  Groningen Netherlands"},{"name":"The George Institute for Global Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3963-2605","authenticated-orcid":false,"given":"Priya","family":"Vart","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University of Groningen University Medical Center Groningen  Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Jongs","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University of Groningen University Medical Center Groningen  Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9276-8380","authenticated-orcid":false,"given":"Brendon L.","family":"Neuen","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Bakris","sequence":"additional","affiliation":[{"name":"American Heart Association Comprehensive Hypertension Center University of Chicago Medicine and Biological Sciences  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-1953","authenticated-orcid":false,"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finnian","family":"McCausland","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran F.","family":"Docherty","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-5317","authenticated-orcid":false,"given":"Pardeep S.","family":"Jhund","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlado","family":"Perkovic","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health  Sydney Australia"},{"name":"University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-3975","authenticated-orcid":false,"given":"John J. 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