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CIHR research Excellence, Diversity and Independence (REDI) Early Career Transition Award

Ayodele Odutayo (Women’s College Hospital) is one of 43 candidates recently awarded in the inaugural CIHR research Excellence, Diversity and Independence (REDI) Early Career Transition award. Dr Odutayo, a KRESCENT fellow, was successful in the Kidney Health pool with the research project entitled “Expanding the use of SGLT-2 inhibitors to improve cardiorenal disease” and was ranked first in the award competition.

See award announcement here
 
Ayodele Odutayo
Dr. Ayodele Odutayo
 
“I’m grateful to be a recipient of the CIHR REDI grant. It is a key milestone for equity, diversity and inclusion. While there has been a lot of effort to support black and racialized communities in securing positions in medical schools and graduate programs, there has been a gap in how many people then transition to an independent research role. The CIHR REDI grant bridges that gap. I could not be happier to learn about the involvement of the Kidney Foundation of Canada (KFOC) in the CIHR REDI program. For me, it is an unequivocal demonstration of the commitment of the KFOC and the broader Nephrology community to closing race and sex-based gaps in opportunity for highly qualified researchers.” - Dr. Ayodele Odutayo

About the Study: Expanding the Use of SGLT-2 inhibitors to improve cardiorenal disease

Background: Heart disease and kidney disease are leading causes of poor health. While these conditions can occur separately, many people will have both medical conditions. The combination of heart and kidney disease is now known as a unique medical condition called “cardiorenal syndrome” and it results in frequent admissions to hospital for heart failure, worsening of kidney function and in some people, the need for dialysis. Improving our understanding of cardiorenal syndrome is an opportunity to improve heart and kidney health at the same time.

A new class of medications know as sodium glucose co-transporter 2 (SGLT2) inhibitors work by changing blood flow and pressure in the kidney (risk factors for kidney damage) and thereby reducing the risk of developing heart failure and/or worsening kidney function by up to 40%. These medications are only approved for a subset of people: those with diabetes, advanced kidney disease or heart failure. Given the effectiveness of SGLT2 inhibitors in preventing heart failure and worsening kidney function, these medications may benefit other people that are at risk for these outcomes.

Purpose: The goal of my research is to understand whether expanding the use of SGLT2 inhibitors to new unstudied patient populations can prevent heart failure and kidney disease. This is because preventing disease would have a larger public health impact than selectively treating people after they have developed heart failure and advanced kidney disease. The unstudied populations I will focus on are people with a recent heart attack and people without diabetes that have risk factors for cardiorenal disease like hypertension and early kidney disease.

Methods: My research will involve analyzing previously conducted clinical trials in people with diabetes who have recently had a heart attack to show that SGLT2 inhibitors work well in this group of people. I have also participated as a sub-investigator in a clinical trial known as EMPACT-MI, which focuses on studying an SGLT2 inhibitor in people who have recently had a heart attack; with the aim of preventing heart failure and advanced kidney disease. This study is now complete, and I will conduct analyses focused on kidney outcomes. Finally, I will design and lead my own clinical trial, called SOLVE, that focuses on people without diabetes who have risk factors for heart failure and advanced kidney disease. These risk factors include hypertension and having small amounts of protein in the urine. SOVLE will use a novel clinical trial design that involves screening medical records to identify and approach potential study participants where they reside. Participants will not have to come into a hospital or study site as part of the study and any clinical outcomes like heart failure or worsening kidney function will be determined based on medical records.

Anticipated Outcomes: I anticipate that my research will show: 1. SGLT2 inhibitors are safe and reduce long term heart failure and worsening kidney function in people who have had a recent heart attack 2. There is a large number of people without diabetes who have risk factors such as hypertension and protein in their urine. Expanding the use of an SGLT2 inhibitor to this population will reduce their risk of heart failure and worsening kidney function.

Patient Engagement: Patient partners were involved in the design and conduct of the now completed EMPACT-MI trial. As well, we have established a team of patient partners that will be involved in the co-creation of the SOLVE study, from the time point of grant submission to recruitment and analysis of the study. Our patient partners offer the insight of many years of lived experience and their experience will be treated as research evidence.

Relevance to Patients/Community: SGLT2 inhibitors are well established treatments for diabetes, advanced kidney disease or heart failure. However, there is a large unmet gap, particularly for people without diabetes who have risk factors for heart failure and kidney disease.

Conclusion: SGLT2 inhibitors are effective and safe medications. Research to expand their use may have important public health impact for reducing heart and kidney disease.

Investigators:

Project lead: Dr Ayodele Odutayo (Women’s College Hospital)
Primary Supervisor: Jacob Udell (Women’s College Hospital)
Co-Supervisors: Husam Abdel-Qadir (Women’s College Hospital), David Cherney (Toronto General Hospital), Michelle Hladunewich (Sunnybrook Research Institute)