dapagliflozin (Forxiga)

following an abbreviated submission:

dapagliflozin (Forxiga®) is accepted for restricted use within NHSScotland.

Indication under review: in adults for the treatment of chronic kidney disease (CKD).

SMC restriction: in patients having individually optimised standard care (including
angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, unless these
are contraindicated or not tolerated), and either, at the start of treatment:

• an estimated glomerular filtration rate (eGFR) of 20 mL/min/1.73m2 up to 45
  mL/min/1.73m², or
• an eGFR of 45 mL/min/1.73m² up to 90 mL/min/1.73m² and either:
  
  o A urine albumin-to-creatinine ratio (uACR) of 22.6 mg/mmol or more, or
  
  o Type 2 Diabetes Mellitus (T2DM).

Dapagliflozin offers an additional treatment choice in the therapeutic class of sodiumglucose co-transporter 2 (SGLT2) inhibitor.

This advice incorporates the previous SMC advice for dapagliflozin in the treatment of CKD
(SMC2428).