DapagliFLOzin in Renal AL Amyloidosis (FLORAL)

Eligibility Criteria

• * Provision of signed and dated informed consent form.
• * Stated willingness to comply with study procedures, including remote telehealth consultations with the study team, confirming availability, and agreeing to use mobile/web applications for study purposes.
• * Age ≥18 years.
• * Histopathologic diagnosis of renal AL amyloidosis confirmed by biopsy of any tissue and evidence of \>1.0 g/day proteinuria without any other identifiable cause.
• * Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0, 1 or 2.
• * Plateau in any renal response (i.e., reduction in proteinuria) for at least 3 months prior to enrollment, as determined by the enrolling physician.
• * Residence in the state of Michigan.
• * Either ongoing first line induction with anti-plasma cell therapy or ongoing post- induction maintenance for \<6 months prior to enrollment.
• * Diagnosis of symptomatic multiple myeloma, including presence of lytic bone disease, plasmacytomas, ≥60% plasma cells in the bone marrow, or hypercalcemia, either currently or in the past.
• * Women of child-bearing potential (i.e., those who have not undergone chemical or surgical sterilization or are not postmenopausal) and who are unwilling to use a medically accepted and reliable form of contraception while participating in the study and for 2 weeks following the last dose of study medication, as determined by the investigator, or have a positive pregnancy test at the time of enrolment or are currently breastfeeding.
• * Known allergic reactions to components of the dapagliflozin.
• * Treatment requiring type 1 or type 2 diabetes mellitus.
• * Baseline eGFR \<25 mL/min/1.73m2.
• * Acute or chronic liver disease with severe impairment of liver function (e.g., ascites, esophageal varices or coagulopathy)
• * Current or previous use of any SGLT2i.
• * Initiation or dose modification of angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) \<3 months prior to enrollment.
• * Active malignancy requiring treatment (other than AL amyloidosis and non-melanoma skin cancers).