Effect of Ertugliflozin on Initial eGFR Decline and Chronic Slope: Analyses from the VERTIS CV Trial
Bibliographic record
Abstract
Background: SGLT2 inhibitors induce an initial reversible eGFR dip, based on natriuresis-induced reductions in glomerular pressure, with a return toward baseline over time in adults with T2DM. Preservation of the chronic eGFR slope by ≥0.75 mL/min/1.73m2/year with treatment predicts protection against CKD progression. We aimed to assess the impact of initial eGFR dip and chronic eGFR slope in the VERTIS CV trial (NCT01986881). Methods: Patients with T2DM and ASCVD were randomized (1:1:1) to ertugliflozin 5 mg, 15 mg or placebo. Analyses assessed pooled ertugliflozin (n=5499) and placebo (n=2747). Patients were divided into 3 tertiles based on initial eGFR change at Week 6 (increase, small change or decrease). Changes in eGFR, hematocrit and uric acid were assessed at Weeks 6, 18, 52 and 156. Chronic eGFR slope/year by random coefficient models was also assessed. Results: Glucosuria-associated effects (ie, uric acid) were larger in the eGFR increase tertile; natriuresis-associated effects (ie, hematocrit) were larger in the eGFR decrease tertile (Fig A, B). The ertugliflozin eGFR decrease tertile had the smallest decline in chronic eGFR slope (Fig C, D). Chronic slopes were similar across the placebo group tertiles and the rate of decline uniformly more rapid (Fig D). Mean placebo-adjusted effect of ertugliflozin on chronic eGFR slope (Weeks 6-156 [95% CI]) was 1.19 (0.95, 1.42) mL/min/1.73 m2/year (Fig E) and >0.75 mL/min/1.73 m2/year in all subgroups. Conclusions: The initial eGFR dip may influence several clinical effects of ertugliflozin. Ertugliflozin has favorable effects on eGFR slope in patients with T2DM and ASCVD. Funding: Commercial Support - Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA in collaboration with Pfizer Inc.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".