Farxiga is recommended by NICE (UK) to treat chronic kidney disease. -AstraZeneca

Why the committee made these recommendations? Management of CKD aims to slow disease progression. Standard care is lifestyle and dietary changes, and usually ACE inhibitors or ARBs. Dapagliflozin is an oral treatment for CKD. The company proposes that dapagliflozin would be used as an add-on to optimised standard care with ACE inhibitors or ARBs, which is narrower than its marketing authorisation. Clinical trial evidence suggests that dapagliflozin plus standard care is more effective than standard care alone. The main clinical trial only included people with an eGFR of 25 ml/min/1.73 m2 to 75 ml/min/1.73 m2 and a uACR of 22.6 mg/mmol to 565 mg/mmol. Evidence is available for dapagliflozin from a different clinical trial for people with CKD and type 2 diabetes and with a uACR of less than 22.6 mg/mmol. There is no clinical trial evidence available for dapagliflozin in people with CKD without type 2 diabetes and with a uACR of less than 22.6 mg/mmol. For the groups for which there is good enough clinical evidence, the cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, dapagliflozin is recommended for these groups as an add-on to optimised standard care including ACE inhibitors or ARBs.