#NephJC Transcript

Healthcare social media transcript of the #NephJC hashtag.
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Dearbhla Kelly @DearbhlaKelly4
European tour tonight! Join me at 8pm BST to discuss this paper #nephjc https://t.co/C2KQ6Iiy9h
Swapnil Hiremath, MD, MPH @hswapnil
RT @DearbhlaKelly4: European tour tonight! Join me at 8pm BST to discuss this paper #nephjc https://t.co/C2KQ6Iiy9h
Dearbhla Kelly @DearbhlaKelly4
RT @rheault_m: @NephJC T0: I've never used SGLT2 inhibitors. But paying attention as type 2 diabetes is increasing in adolescents.…
Dearbhla Kelly @DearbhlaKelly4
T2DM on the rise among adolescents - all the more reason to familiarise ourselves with new tools to reduce CVS risk and CKD #NephJC https://t.co/gkkregUlTH
Tulun Sokit @tulunsokit
RT @DearbhlaKelly4: T2DM on the rise among adolescents - all the more reason to familiarise ourselves with new tools to reduce CVS risk…
SP @caring4u2
RT @hswapnil: Swapnil Hiremath #nephjc cofounder, from @OttawaHospital #askASN Lurking tonight https://t.co/PoHec0gEoO
Dearbhla Kelly @DearbhlaKelly4
The awkward moment when you realise that you have no (twitter) endocrinology friends to invite to your #NephJC on Canagliflozin 🙄
Dearbhla Kelly @DearbhlaKelly4
Anyone have a friendly neighbourhood diabetes doc I could borrow? I promise I will return! @NephJC @toates_19 @DrMattGB https://t.co/ui0eH6CdAt
Matt Graham-Brown @DrMattGB
RT @DearbhlaKelly4: Anyone have a friendly neighbourhood diabetes doc I could borrow? I promise I will return! @NephJC @toates_19
Nephrology Jrnl Club @NephJC
Would love to see some diabetes docs tonight at 8pm BST to discuss CANVAS trial! #NephJC https://t.co/x4DEAxmTri
Rupe Major @rupeemaj
RT @NephJC: Would love to see some diabetes docs tonight at 8pm BST to discuss CANVAS trial! #NephJC https://t.co/x4DEAxmTri
Max Rosenthal @maxrosent
RT @hswapnil: Here is letter that @DogICUma mentioned #NephJC https://t.co/Ta1vE7grdC & reply: https://t.co/rPUjSUCC03 #SPLITtrial on clust…
Nephrology Jrnl Club @NephJC
T-10minutes to NephJC! #NephJC
Tom Oates @toates_19
@domcavlan @parthaskar @hormone_doc @doctorcaldwell to name a few...#nephjc https://t.co/WOc3e0ZrlW
Nephrology Jrnl Club @NephJC
Greetings from Dublin! Welcome to NephJC.The topic for tonight:Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. #NephJC
Nephrology Jrnl Club @NephJC
Please introduce yourself and disclose any COIs. All lurkers welcome! #NephJC
Tom Oates @toates_19
Hi Tom, from London. Multitasking. COIs: maybe suffering from SGLT2i evidence fatigue (thanks @drpaddymark & David Wheeler) #nephjc
OmarTaco MD, MSc @Errantnephron
Omar, nephrologist in Barcelona, #NSMC intern, COI: love all my toes 👣 #nephjc
Matt Graham-Brown @DrMattGB
Evening! Matt GB Leicester, UK. Spoke at the @rasprclub dinner at ASN 2016 and hat was sponsored by Janssen #nephjc
Rupe Major @rupeemaj
Always forget #NephJC
Nephrology Jrnl Club @NephJC
Acute on chronic fatigue expected tonight then #nephjc https://t.co/4Qn3vTVO96
Nephrology Jrnl Club @NephJC
@RupeeMaj Welcome Rupe! Yes its definitely not as glossy as EMPA-REG! #nephjc
Matt Graham-Brown @DrMattGB
#NephJC https://t.co/yO8nOISW4K
Rupe Major @rupeemaj
#NephJC Rupe Major, renal spr, Leicester. COI: I thought SGLT2 'worked' prior to reading this paper
D.Guerrot @dguerrot
@NephJC Hi, Dominique Guerrot, Nephrologist in Rouen, France. Just lurking #NephJC
Lynne Sykes @AKIfellow
Lynne, northwest, mostly lurking as busy with work, no COI #nephjc
Nephrology Jrnl Club @NephJC
@Errantnephron Welcome Omar! Don't we all! #NephJC
Tom Oates @toates_19
Also currently revising (writing) my talk for the Leicester lads and lasses tomorrow #nephjc
Nephrology Jrnl Club @NephJC
@DrMattGB @rasprclub Hi Matt! Sorry to have missed ukkw but the tweeting was stellar! #NephJC
Tom Oates @toates_19
@Errantnephron 👏👏👏 #nephjc
Matt Graham-Brown @DrMattGB
Which we are looking forward to immensely! https://t.co/JWFaRPROl8
Nephrology Jrnl Club @NephJC
Tonight we are discussing the recent @NEJM RCT https://t.co/O9b0Bo1yie #NephJC
Rupe Major @rupeemaj
RT @toates_19: Also currently revising (writing) my talk for the Leicester lads and lasses tomorrow #nephjc
Nephrology Jrnl Club @NephJC
T0: Who remembers the original SGLT2i trial (EMPA-REG-OUTCOME/Renal) here? #NephJC
Talk_Leicester @talk_leicester
RT @DrMattGB: Evening! Matt GB Leicester, UK. Spoke at the @rasprclub dinner at ASN 2016 and hat was sponsored by Janssen #nephjc
Tom Oates @toates_19
@RupeeMaj It's mostly jokes #nephgags #nephjc
Nephrology Jrnl Club @NephJC
T0:Empagliflozosin reduced the risk of major CVS events and slowed progression of renal disease in T2DM at high risk for CVS events.#nephjc
Rupe Major @rupeemaj
@NephJC A recap would be useful #nephjc
Tom Oates @toates_19
We flogged it in #nephjc, so I do https://t.co/xYib4aemZz
Nephrology Jrnl Club @NephJC
T0: Does anyone prescribe this now and who for? Any complications encountered? #NephJC
Tomas Rohal @calvapo
@NephJC @NEJM Sorry, guys, late from work, not making it... Good evening all! #nephjc
Nephrology Jrnl Club @NephJC
@toates_19 Best bloggers/floggers around! #NephJC
Matt Graham-Brown @DrMattGB
@NephJC Etched into the brain as we hammered it somewhat! #nephjc
Matt Graham-Brown @DrMattGB
RT @NephJC: T0:Empagliflozosin reduced the risk of major CVS events and slowed progression of renal disease in T2DM at high risk for CVS ev…
Tom Oates @toates_19
/ @NephJC I am yet to prescribe an SGLT2i - guess most benefit for pts who maybe aren't in our clinics #nephjc
Talk_Leicester @talk_leicester
RT @toates_19: Also currently revising (writing) my talk for the Leicester lads and lasses tomorrow #nephjc
OmarTaco MD, MSc @Errantnephron
@RupeeMaj @NephJC Comparison between the two trials #NephJC https://t.co/yZJdx911kB
Rupe Major @rupeemaj
RT @NephJC: T0:Empagliflozosin reduced the risk of major CVS events and slowed progression of renal disease in T2DM at high risk for CVS ev…
Rupe Major @rupeemaj
@NephJC #nephjc
OmarTaco MD, MSc @Errantnephron
@NephJC Seem some with GFR>30, prescribed by Endo #nephjc
Rupe Major @rupeemaj
@toates_19 @NephJC Agree #nephjc
Nephrology Jrnl Club @NephJC
T0:I can't honestly say that I have prescribing Empagliflozin but I've nodded approvingly when diabeticrenal patients on them attend #nephjc
Paddy Mark @drpaddymark
@toates_19 Not joining but thinking of you on hols from south of France #NephJC
Matt Graham-Brown @DrMattGB
RT @Errantnephron: @RupeeMaj @NephJC Comparison between the two trials #NephJC https://t.co/yZJdx911kB
Fra Ian @caioqualunque
@toates_19 @NephJC Can you prescribe it directly? I can only advice diabetologist to prescribe it. So far, I had only the chance to advice to stop it #nephjc
Nephrology Jrnl Club @NephJC
RT @toates_19: / @NephJC I am yet to prescribe an SGLT2i - guess most benefit for pts who maybe aren't in our clinics #nephjc
Garima Aggarwal @gag_aggarwal
@NephJC #nephjc https://t.co/cOqbBcnAw0
Nephrology Jrnl Club @NephJC
RT @caioqualunque: @toates_19 @NephJC Can you prescribe it directly? I can only advice diabetologist to prescribe it. So far, I had on…
Tom Oates @toates_19
@drpaddymark Have a glass of burgundy on us Dr M #nephjc
Nephrology Jrnl Club @NephJC
T0: Canagliflozin is not as bioavailable for more SGLT2i specific. CANVAS was designed to assess cardiovascular safety and efficacy #NephJC
Nephrology Jrnl Club @NephJC
Thanks Omar! #NephJC https://t.co/zG723JzIen
Tom Oates @toates_19
For those of us based in the UK here's what @NICEcomms says (so far) on SGLT2i https://t.co/K7yJaiqS0F #nephjc
Nephrology Jrnl Club @NephJC
RT @toates_19: @drpaddymark Have a glass of burgundy on us Dr M #nephjc
Nephrology Jrnl Club @NephJC
RT @toates_19: For those of us based in the UK here's what @NICEcomms says (so far) on SGLT2i https://t.co/K7yJaiqS0F #nephjc
Nephrology Jrnl Club @NephJC
T1: CANVAS (pre FDA approval) + CANVAR-R (Post) = CANVAS program to maximize statistical power. Any issues with this study design? #NephJC
Matt Graham-Brown @DrMattGB
RT @toates_19: For those of us based in the UK here's what @NICEcomms says (so far) on SGLT2i https://t.co/K7yJaiqS0F #nephjc
D.Guerrot @dguerrot
@toates_19 @drpaddymark That's a bit north Tom. ( My contribution to today's #nephjc ) ;-)
Nephrology Jrnl Club @NephJC
Complex and somewhat controversial Study design here #NephJC https://t.co/6sO0AsahVs
Matt Graham-Brown @DrMattGB
@NephJC No issues, studies were well designed followed FDA guidance for non-inferiority meticulously. Sensible putting together #nephjc
Matt Graham-Brown @DrMattGB
@NephJC I don't think controversial. More patients, better one big study than 2 smaller #nephjc
Paddy Mark @drpaddymark
@dguerrot @toates_19 Better clarify. Provençal rose (can't get iPhone to put acute on the e) #nephJC back to canvas
Nephrology Jrnl Club @NephJC
T1: Essentially only phase 1 of original trial completed combined with another large sister trial #nephjc https://t.co/FOf6DgeIV7
Tom Oates @toates_19
@dguerrot @drpaddymark Hahaha but @drpaddymark is a discerning man and knows his AOC from his VDQS #FrenchWine #nephjc
Nephrology Jrnl Club @NephJC
RT @toates_19: @dguerrot @drpaddymark Hahaha but @drpaddymark is a discerning man and knows his AOC from his VDQS #FrenchWine #nephjc
Fra Ian @caioqualunque
High n of pts enrolled, ITT and a reasonable n of events... I think it is enough #NephJC
Nephrology Jrnl Club @NephJC
RT @DrMattGB: @NephJC No issues, studies were well designed followed FDA guidance for non-inferiority meticulously. Sensible putting togeth…
Nephrology Jrnl Club @NephJC
RT @DrMattGB: @NephJC I don't think controversial. More patients, better one big study than 2 smaller #nephjc
Nephrology Jrnl Club @NephJC
RT @drpaddymark: @dguerrot @toates_19 Better clarify. Provençal rose (can't get iPhone to put acute on the e) #nephJC back to canvas
Nephrology Jrnl Club @NephJC
T1: Inclusion criteria: T2DM with GFR>30, age>30 with CVS disease or age>50 with 2 or more RFs #NephJC
Nephrology Jrnl Club @NephJC
RT @caioqualunque: High n of pts enrolled, ITT and a reasonable n of events... I think it is enough #NephJC
Nephrology Jrnl Club @NephJC
Explicit hierarchy of outcomes #nephjc https://t.co/IxVZFdlMN4
Nephrology Jrnl Club @NephJC
T1: Note dose differences between CANVAS and CANVAS-R and placebo included standard of care mgmt for glycemia, BP, CVS risk #NephJC
Nephrology Jrnl Club @NephJC
T1: Composite primary outcome: death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. #NephJC
Rupe Major @rupeemaj
@DrMattGB @NephJC #nephjc took me a while to get head round design, think we'll see more and more RCTs like this in all areas
Nephrology Jrnl Club @NephJC
T1: Note funding- The trials were sponsored by Janssen Research and Development and 4 authors were co-employees. #NephJC
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: @DrMattGB @NephJC #nephjc took me a while to get head round design, think we'll see more and more RCTs like this in all areas
Edoardo Melilli @EdoardoMelilli
@caioqualunque @toates_19 @NephJC Yes, in Spain we can. Hello #nephjc I m in invisible mode 👻
Nephrology Jrnl Club @NephJC
T2: Moving onto results – N=10142 randomised with ITT analysis #NephJC
Edoardo Melilli @EdoardoMelilli
@caioqualunque @toates_19 @NephJC Prescribed just one time #nephjc
Tom Oates @toates_19
T1: I think the trial design suggests a pragmatism after the FDA approval was granted #nephjc
Rupe Major @rupeemaj
@NephJC #nephjc also used a professional med writing service paid for by sponsor
Nephrology Jrnl Club @NephJC
@EdoardoMelilli @caioqualunque @toates_19 Hi Edoardo! How stealthy you are! #NephJC
Nephrology Jrnl Club @NephJC
RT @toates_19: T1: I think the trial design suggests a pragmatism after the FDA approval was granted #nephjc
Matt Graham-Brown @DrMattGB
@toates_19 Correct. Interim analysis suggested safety so FDA granted licence. Good idea to combine numbers thereafter IMO #nephjc
Nephrology Jrnl Club @NephJC
Any major differences in baseline characteristics? #NephJC https://t.co/sKAI1zcynK
Rupe Major @rupeemaj
@NephJC T2: ~70% had normoalbuminuria #nephjc
Nephrology Jrnl Club @NephJC
T2: mean age 63 yrs, 60% men with mean duration of DM 13.5 yrs. #NephJC
Matt Graham-Brown @DrMattGB
RT @NephJC: Any major differences in baseline characteristics? #NephJC https://t.co/sKAI1zcynK
Tom Oates @toates_19
.@NephJC not sure the grps were fully balanced for vascular diseases by eye #nephjc
Nephrology Jrnl Club @NephJC
T2: Mean GFR was 76.5 mL/min, median ACR was 12.3, 22.6% microalbuminuria, 7.6%macroalbuminuria, and 65.6% had a history of CV ds #nephjc
Nephrology Jrnl Club @NephJC
RT @toates_19: .@NephJC not sure the grps were fully balanced for vascular diseases by eye #nephjc
Rupe Major @rupeemaj
@NephJC T2: original protocol stated MDRD eGFR, NEJM doesn't state eGFR formula used (as far as I can see) #nephjc
Nephrology Jrnl Club @NephJC
@toates_19 Yes maybe more disease in the placebo group which makes the adverse events all the more interesting! #NephJC
Nephrology Jrnl Club @NephJC
RT @DrMattGB: @toates_19 Correct. Interim analysis suggested safety so FDA granted licence. Good idea to combine numbers thereafter IMO #ne
Fra Ian @caioqualunque
If the study really included pts w/ high cV risk, Microalbuminuria is not very sensitive to identify CKD pts at CV risk after all 🤔😔 #nephjc https://t.co/BOVkk9i5Rv
Nephrology Jrnl Club @NephJC
T2: Definitely multi-center - 30 countries with 667 sites! #NephJC
Rupe Major @rupeemaj
@NephJC @toates_19 Can't see any p values and with that many variables bound to be some 'unbalanced' variables #nephjc
Nephrology Jrnl Club @NephJC
Baseline therapy in active vs placebo group #NephJC https://t.co/TStvV9nih0
Edoardo Melilli @EdoardoMelilli
@NephJC @toates_19 Really a big difference? I don't see the #p. #nephjc
Tom Oates @toates_19
,@RupeeMaj @NephJC don't make me give the "p values are inappropriate in a baseline table" talk #nephjc
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: @NephJC @toates_19 Can't see any p values and with that many variables bound to be some 'unbalanced' variables #nephjc
Rupe Major @rupeemaj
@caioqualunque #nephjc but even small rise in ACR group predictive of CV risk even in 'normoalbuminuria' group
Matt Graham-Brown @DrMattGB
@RupeeMaj @NephJC @toates_19 There is an explanation for this in the #nephjc blog by @kidney_boy
Nephrology Jrnl Club @NephJC
@RupeeMaj @toates_19 Yes would be really useful to see some p values here! #nephjc
Nephrology Jrnl Club @NephJC
RT @toates_19: ,@RupeeMaj @NephJC don't make me give the "p values are inappropriate in a baseline table" talk #nephjc
Rupe Major @rupeemaj
@toates_19 @NephJC #nephjc force of habit to include them! Not necessarily correct
Nephrology Jrnl Club @NephJC
T2: Canagliflozin reduced blood sugar, wt and BP #nephjc https://t.co/WYFPZzGSWI
Matt Graham-Brown @DrMattGB
@RupeeMaj @toates_19 @NephJC You can get rid of necessarily! #nephjc
Matt Graham-Brown @DrMattGB
RT @NephJC: T2: Canagliflozin reduced blood sugar, wt and BP #nephjc https://t.co/WYFPZzGSWI
Pete @peteturton85
RT @toates_19: ,@RupeeMaj @NephJC don't make me give the "p values are inappropriate in a baseline table" talk #nephjc
Tom Oates @toates_19
Highly recommend #runthejewels as soundtrack to #nephjc https://t.co/4BrfGg7EEj
Nephrology Jrnl Club @NephJC
T2: Like EMPA-Reg, it did reduce overall mortality but no sig diff in CV mortality #nephjc https://t.co/bnLiUpT5VS
Nephrology Jrnl Club @NephJC
RT @caioqualunque: If the study really included pts w/ high cV risk, Microalbuminuria is not very sensitive to identify CKD pts at CV…
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: @caioqualunque #nephjc but even small rise in ACR group predictive of CV risk even in 'normoalbuminuria' group
Nephrology Jrnl Club @NephJC
RT @NephJC: T2: Like EMPA-Reg, it did reduce overall mortality but no sig diff in CV mortality #nephjc https://t.co/bnLiUpT5VS
Nephrology Jrnl Club @NephJC
RT @toates_19: Highly recommend #runthejewels as soundtrack to #nephjc https://t.co/4BrfGg7EEj
Tom Oates @toates_19
.@NephJC someone should do bioimpedance studies on SGLT2i treated pts to quantify what wt loss is calorific and what diuretic #nephjc
OmarTaco MD, MSc @Errantnephron
@RupeeMaj @NephJC MDRD eGFT in the supplement https://t.co/36JkincbBD #NephJC https://t.co/FllpbupTZ1
Nephrology Jrnl Club @NephJC
T2: Mean follow up 188.2 weeks –do we need longer to see specific CV mortality benefit in this group? #NephJC
Rupe Major @rupeemaj
@DrMattGB @NephJC @toates_19 @kidney_boy #nephjc are you referring to #randomgate ?
Fra Ian @caioqualunque
@toates_19 BBC iPlayer only works in UK #nephjc
Nephrology Jrnl Club @NephJC
Yes interesting as there was an interaction with diuretics with added benefit #nephjc https://t.co/Hv2mUXtWXF
Nephrology Jrnl Club @NephJC
RT @Errantnephron: @RupeeMaj @NephJC MDRD eGFT in the supplement https://t.co/36JkincbBD #NephJC https://t.co/FllpbupTZ1
Matt Graham-Brown @DrMattGB
@toates_19 @NephJC #nephjc Can do better than bioimpedance. SGLT-2's are crying out for mechanistic studies to assess acute effects on cardiac loading...
Nephrology Jrnl Club @NephJC
T2: details of outcomes following the analytic plan #nephjc https://t.co/GNebV2kIwu
Rupe Major @rupeemaj
@toates_19 @NephJC #nephjc my monies on h2o
D.Guerrot @dguerrot
@NephJC How do you interpret the reducing difference in HbA1c curves, while other differences remain stable? Persistent effect on Na>glyc? #NephJC
Edoardo Melilli @EdoardoMelilli
@NephJC Maybe 5 years better than 3.6 years #nephjc
Matt Graham-Brown @DrMattGB
@toates_19 @NephJC I suspect they are brilliant diuretics and this alone accounts for much of the benefit @GauravGulsin - any thoughts? #nephjc
Nephrology Jrnl Club @NephJC
T2: Exploratory renal outcomes - are you persuaded to prescribe? #nephjc https://t.co/a3HOU1kbXO
Matt Graham-Brown @DrMattGB
@NephJC Ha! I don't see any patients with high enough GFRs to prescribe them! #nephjc
Rupe Major @rupeemaj
@DrMattGB @toates_19 @NephJC #nephjc start with bioimpedence before getting the MRI scanner out
Fra Ian @caioqualunque
@toates_19 @NephJC I wonder what would happen using SGLT2, vaptans and high dose diuretics altogether... I wouldn't be there #nephjc
Nephrology Jrnl Club @NephJC
Yes good thought! See diuretics slide! #NephJC https://t.co/ZIb4XS6MvQ
Matt Graham-Brown @DrMattGB
@RupeeMaj @toates_19 @NephJC Probably too late - expect the MRI scanner is already out! #nephjc
Nephrology Jrnl Club @NephJC
RT @DrMattGB: @toates_19 @NephJC I suspect they are brilliant diuretics and this alone accounts for much of the benefit…
Tom Oates @toates_19
@NephJC `40% reduction in eGFR is a promising endpoint - ask @willkidney #nephjc
Gaurav Gulsin @gauravgulsin
RT @DrMattGB: @toates_19 @NephJC I suspect they are brilliant diuretics and this alone accounts for much of the benefit…
Nephrology Jrnl Club @NephJC
T2: Potentially some added benefit when used with diuretics or beta blockers #nephjc https://t.co/isaNAQmKLa
Edoardo Melilli @EdoardoMelilli
@NephJC Not for #ckd patients or to delay progression, if #grf is enough high yes I will prescribe data on survival are quite impressive IMO #nephjc
Rupe Major @rupeemaj
@toates_19 @NephJC @willkidney #nephjc but no data on individual change in eGFR as was originally promised in protocol
Tom Oates @toates_19
`@NephJC 40% eGFR change is a promising outcome (ask @willkidney) #nephjc
Gaurav Gulsin @gauravgulsin
RT @DrMattGB: @toates_19 @NephJC #nephjc Can do better than bioimpedance. SGLT-2's are crying out for mechanistic studies to asse…
Nephrology Jrnl Club @NephJC
T2: what do you think of the renal outcome? Change in ACR with time #nephjc https://t.co/SlDSOIxORq
Nephrology Jrnl Club @NephJC
T2: composite renal outcomes #nephjc https://t.co/wVlx1Q2MD3
Rupe Major @rupeemaj
#nephjc T2: have I missed it? No primary outcome by baseline albuminuria status
ab153 @im453
RT @NephJC: T2: Potentially some added benefit when used with diuretics or beta blockers #nephjc https://t.co/isaNAQmKLa
Matt Graham-Brown @DrMattGB
#nephjc https://t.co/odWReFgUAA
ab153 @im453
RT @NephJC: T2: Canagliflozin reduced blood sugar, wt and BP #nephjc https://t.co/WYFPZzGSWI
Matt Graham-Brown @DrMattGB
#nephjc https://t.co/MY3mKntEme
Edoardo Melilli @EdoardoMelilli
@NephJC Better blood pressure control? #nephjc
ab153 @im453
RT @NephJC: Yes interesting as there was an interaction with diuretics with added benefit #nephjc https://t.co/Hv2mUXtWXF
Nephrology Jrnl Club @NephJC
T2: Here are the adverse events: urogenital infections higher from glycosuria #nephjc https://t.co/cI4eRooIhC
Rupe Major @rupeemaj
RT @DrMattGB: @toates_19 @NephJC I suspect they are brilliant diuretics and this alone accounts for much of the benefit…
Fra Ian @caioqualunque
@NephJC #nephjc very interesting data, but I'd be more interested in knowing how many pts changed CKD A category: A3➡A2️➡️A1
Edoardo Melilli @EdoardoMelilli
@NephJC Maybe better avoid if previous recurrent UTI or #kidneytransplant IMO #nephjc
Edoardo Melilli @EdoardoMelilli
RT @NephJC: T2: Here are the adverse events: urogenital infections higher from glycosuria #nephjc https://t.co/cI4eRooIhC
Nephrology Jrnl Club @NephJC
T2: Volume depletion was higher, but AKI or hyperkalemia were not significantly different. #NephJC
ab153 @im453
RT @Errantnephron: @RupeeMaj @NephJC Comparison between the two trials #NephJC https://t.co/yZJdx911kB
Nephrology Jrnl Club @NephJC
T2: Very surprisingly, more amputations with Canagliflozosin independent of other RFs #nephjc https://t.co/6ik0QXZYOn
Rupe Major @rupeemaj
#nephjc T2: serious adverse events overall higher in placebo but each individual adverse event is higher in Canagliflozin group
Nephrology Jrnl Club @NephJC
RT @caioqualunque: @NephJC #nephjc very interesting data, but I'd be more interested in knowing how many pts changed CKD A category: A3➡A2️…
Nephrology Jrnl Club @NephJC
RT @EdoardoMelilli: @NephJC Maybe better avoid if previous recurrent UTI or #kidneytransplant IMO #nephjc
Matt Graham-Brown @DrMattGB
@NephJC ⬆️Amputations were the standout AE in the data. Needs further Ix. Can't think of a biologically plausible explanation - anyone? #nephjc
Nephrology Jrnl Club @NephJC
T2: More fractures and renal adverse events #NephJC
Fra Ian @caioqualunque
@EdoardoMelilli @NephJC So rule n 2.... do not use if there is a urinary catheter ?⁉️ #nephjc
Rupe Major @rupeemaj
#nephjc ?suggest clustering of adverse events in treatment group
Nephrology Jrnl Club @NephJC
T3: Final thoughts on this interesting trial? Will you be prescribing SGLT2i for putative CVS or renal benefits? Or deprescribing?#NephJC
Kevin J. Fowler @gratefull080504
Thank you Paul Conway for representing the #patientvoice with the #device industry This an unmet need cc @knightra @KidneyPatients #nephJC https://t.co/FfJ5OZnhET
Nephrology Jrnl Club @NephJC
T3: How do we explain the increased amputations/fractures? #NephJC
Edoardo Melilli @EdoardoMelilli
@DrMattGB @NephJC Next time add to bioimpedancy also an ankle brachial index #nephjc 😬
OmarTaco MD, MSc @Errantnephron
@NephJC Amputation risk is a class effect? Think is STILL an open question #NephJC
Rupe Major @rupeemaj
@NephJC #nephjc increased urinary calcium loss?? Not sure
Matt Graham-Brown @DrMattGB
@NephJC Great to have a second (big) trial showing benefit for manypatients. Work to do examining AEs, but very encouraging for class effect #nephjc
Matt Graham-Brown @DrMattGB
@RupeeMaj @NephJC Not sure 🤔 #nephjc
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: #nephjc T2: serious adverse events overall higher in placebo but each individual adverse event is higher in Canagliflozin gro…
Nephrology Jrnl Club @NephJC
RT @DrMattGB: @NephJC ⬆️Amputations were the standout AE in the data. Needs further Ix. Can't think of a biologically plausible e…
Rupe Major @rupeemaj
@DrMattGB @NephJC #nephjc https://t.co/xlgXjwceHW
D.Guerrot @dguerrot
@RupeeMaj @NephJC Relative volume depletion with increased repeated microischemia ? #NephJC
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: #nephjc ?suggest clustering of adverse events in treatment group
Nephrology Jrnl Club @NephJC
RT @Errantnephron: @NephJC Amputation risk is a class effect? Think is STILL an open question #NephJC
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: @NephJC #nephjc increased urinary calcium loss?? Not sure
Nephrology Jrnl Club @NephJC
RT @DrMattGB: @NephJC Great to have a second (big) trial showing benefit for manypatients. Work to do examining AEs, but very enc…
Rupe Major @rupeemaj
RT @DrMattGB: @NephJC Great to have a second (big) trial showing benefit for manypatients. Work to do examining AEs, but very enc…
D.Guerrot @dguerrot
@RupeeMaj @NephJC Surprisingly no dose effect though #NephJC
Nephrology Jrnl Club @NephJC
RT @RupeeMaj: @DrMattGB @NephJC #nephjc https://t.co/xlgXjwceHW
Nephrology Jrnl Club @NephJC
RT @dguerrot: @RupeeMaj @NephJC Relative volume depletion with increased repeated microischemia ? #NephJC
Fra Ian @caioqualunque
@RupeeMaj @NephJC #nephjc I can't figure a renal mechanism, If we have to believe in these findings, I think this must be related to pleyotropic effects
Rupe Major @rupeemaj
@DrMattGB @NephJC #nephjc increased tubular PO4 resorption
Nephrology Jrnl Club @NephJC
Think it might be time to wrap up! Hopefully we haven't contracted some of @toates_19 chronic fatigue! Thanks everyone for coming! #nephjc
Tom Oates @toates_19
Great work @DearbhlaKelly4 ! Great fun! #nephjc
Fra Ian @caioqualunque
@dguerrot @RupeeMaj @NephJC So why not increased Cardiac events? Weight/BP changes aren't consistent with this hypothesis #nephjc
Matt Graham-Brown @DrMattGB
@NephJC @toates_19 Thanks @DearbhlaKelly4 - nice chatting all. à la prochaine! #nephjc
Rupe Major @rupeemaj
@NephJC @toates_19 #nephjc thanks for informative chat, plenty learnt from a week performed RCT
OmarTaco MD, MSc @Errantnephron
@DrMattGB @NephJC @toates_19 Immediate follow to @DearbhlaKelly4, thanks❗️ #nephjc
Rupe Major @rupeemaj
@NephJC @toates_19 #nephjc thanks for informative chat, plenty learnt from a well performed RCT
Edoardo Melilli @EdoardoMelilli
@NephJC @toates_19 great #nephjc including in the summer season
Rupe Major @rupeemaj
@caioqualunque @NephJC #nephjc https://t.co/xlgXjwceHW
Fra Ian @caioqualunque
@DearbhlaKelly4 you was such a big master hosting this chat! Well done #NephJC
Tomas Rohal @calvapo
@EdoardoMelilli @NephJC Most of my patients transplanted or pretty advanced CKD... Haven't prescribed yet #nephjc
Fra Ian @caioqualunque
RT @RupeeMaj: @caioqualunque @NephJC #nephjc https://t.co/xlgXjwceHW
Nephrology Jrnl Club @NephJC
#NephJC has been busy https://t.co/fma9H7opbD
Joel Topf, MD FACP @kidney_boy
RT @NephJC: #NephJC has been busy https://t.co/fma9H7opbD
Arinarami @nephrologyunit
RT @NephJC: Tonight we are discussing the recent @NEJM RCT https://t.co/O9b0Bo1yie #NephJC
Arinarami @nephrologyunit
RT @NephJC: T2: composite renal outcomes #nephjc https://t.co/wVlx1Q2MD3
Arinarami @nephrologyunit
RT @NephJC: Explicit hierarchy of outcomes #nephjc https://t.co/IxVZFdlMN4
Arinarami @nephrologyunit
RT @NephJC: Baseline therapy in active vs placebo group #NephJC https://t.co/TStvV9nih0
Arinarami @nephrologyunit
RT @NephJC: Complex and somewhat controversial Study design here #NephJC https://t.co/6sO0AsahVs
Arinarami @nephrologyunit
RT @NephJC: T2: details of outcomes following the analytic plan #nephjc https://t.co/GNebV2kIwu
Arinarami @nephrologyunit
RT @NephJC: T2: what do you think of the renal outcome? Change in ACR with time #nephjc https://t.co/SlDSOIxORq
Arinarami @nephrologyunit
RT @NephJC: T2: Mean follow up 188.2 weeks –do we need longer to see specific CV mortality benefit in this group? #NephJC
Arinarami @nephrologyunit
RT @NephJC: T2: Volume depletion was higher, but AKI or hyperkalemia were not significantly different. #NephJC
Arinarami @nephrologyunit
RT @NephJC: T3: How do we explain the increased amputations/fractures? #NephJC
Arinarami @nephrologyunit
RT @NephJC: T2: Exploratory renal outcomes - are you persuaded to prescribe? #nephjc https://t.co/a3HOU1kbXO
Arinarami @nephrologyunit
RT @NephJC: Any major differences in baseline characteristics? #NephJC https://t.co/sKAI1zcynK
Arinarami @nephrologyunit
RT @NephJC: T2: Like EMPA-Reg, it did reduce overall mortality but no sig diff in CV mortality #nephjc https://t.co/bnLiUpT5VS
Arinarami @nephrologyunit
RT @NephJC: T2: Potentially some added benefit when used with diuretics or beta blockers #nephjc https://t.co/isaNAQmKLa
Arinarami @nephrologyunit
RT @NephJC: T0: Who remembers the original SGLT2i trial (EMPA-REG-OUTCOME/Renal) here? #NephJC
Arinarami @nephrologyunit
RT @NephJC: T2: Here are the adverse events: urogenital infections higher from glycosuria #nephjc https://t.co/cI4eRooIhC
Arinarami @nephrologyunit
RT @NephJC: T0: Canagliflozin is not as bioavailable for more SGLT2i specific. CANVAS was designed to assess cardiovascular safety and effi…
Arinarami @nephrologyunit
RT @NephJC: Greetings from Dublin! Welcome to NephJC.The topic for tonight:Canagliflozin and Cardiovascular and Renal Events in Type 2 Diab…
Arinarami @nephrologyunit
RT @NephJC: T0:I can't honestly say that I have prescribing Empagliflozin but I've nodded approvingly when diabeticrenal patients on them a…
Arinarami @nephrologyunit
RT @NephJC: T0:Empagliflozosin reduced the risk of major CVS events and slowed progression of renal disease in T2DM at high risk for CVS ev…
Mana @manasigh
RT @Errantnephron: @RupeeMaj @NephJC Comparison between the two trials #NephJC https://t.co/yZJdx911kB
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