Extension of further conditions for SGLT2 inhibitors following recent GVS advice (22 June 2021)
Zorginstituut Nederland has completed its assessment whether the further conditions of SGLT-2 inhibitors canagliflozin (Invokana®), dapagliflozin (Forxiga®) and empagliflozin (Jardiance®) could be further extended. The Zorginstituut's advice is to extend the List 2 conditions of the SGLT-2 inhibitors to include patients with chronic kidney damage.
Registered indication
On 22 June 2021 the National Health Care Institute advised the State Secretary of Medical Care to extend the List 2 conditions of the SGLT-2 inhibitors canagliflozin (Invokana®), dapagliflozin (Forxiga®) and empagliflozin (Jardiance®) as follows:
For the treatment of adults with type 2 diabetes mellitus with a very high risk of cardiovascular disease:
- previously proven cardiovascular diseases;
- chronic kidney damage with
- eGFR 30-59 ml/min per 1.73m2 with moderately elevated albuminuria (ACR> 3 mg/mmol) or
- eGFR ≥ 60 ml/min per 1.73m2 with severely elevated albuminuria (ACR>30 mg/mmol).
The NIV-NHG Guideline Commission is now requesting the Zorginstituut to extend the further conditions to include patients with chronic kidney damage with eGFR 30-44 ml/min per 1.73m2 without albuminuria.
Zorginstiuut's advice
On the basis of the considerations mentioned in the report, the Zorginstituut advises the State Secretary to extend the List 2 conditions of the SGLT-2 inhibitors canagliflozin (Invokana®), dapagliflozin (Forxiga®) and empagliflozin (Jardiance®) to include patients with chronic kidney damage with eGFR 30-44 ml/min per 1.73m2 without albuminuria. The proposed extension is accompanied by limited additional costs.
The new condition is as follows:
For the treatment of adults with type 2 diabetes mellitus with a very high risk of cardiovascular disease:
- previously proven cardiovascular diseases; and/or
- chronic kidney damage with:
- eGFR 30-44 ml/min per 1.73m2 without albuminuria, or;
- eGFR 30-59 ml/min per 1.73m2 with moderately elevated albuminuria (ACR> 3 mg/mmol) or;
- eGFR ≥ 60 ml/min per 1.73m2 with severely elevated albuminuria (ACR>30 mg/mmol).