Exenatide twice-daily does not affect renal function or albuminuria compared to titrated insulin glargine in patients with type 2 diabetes mellitus: A post-hoc analysis of a 52-week randomised trial.

• To compare the effects of long-term treatment with the GLP-1RA exenatide twice-daily versus titrated insulin glargine (iGlar) on renal function and albuminuria in type 2 diabetes (T2DM) patients.We post-hoc evaluated renal outcome-data of 54 overweight T2DM patients (mean ±SD age 60±8years, HbA1c 7.5±0.9%, eGFR 86±16mL/min/1.73m2, median [IQR] urinary albumin-to-creatinine-ratio (UACR) 0.75 [0.44-1.29]mg/mmol) randomised to exenatide 10µg twice-daily or titrated iGlar on-top-of metformin for 52-weeks. Renal efficacy endpoints were change in creatinine clearance (CrCl) and albuminuria (urinary albumin-excretion [UAE] and UACR) based on 24-h urines, collected at baseline and Week-52. eGFR and exploratory endpoints were collected throughout the intervention-period, and after a 4-week wash-out.HbA1c-reductions were similar with exenatide (mean±SEM -0.80±0.10%) and iGlar (-0.79±0.14%; treatment-difference 0.02%; 95% CI -0.31 to 0.42%). Change from baseline to Week-52 in CrCl, UAE or UACR did not statistically differ; only iGlar reduced albuminuria (P<0.05; within-group). eGFR decreased from baseline to Week-4 with exenatide (-3.9±2.1mL/min/1.73m2; P=0.069) and iGlar (-2.7±1.2mL/min/1.73m2; P=0.034), without treatment-differences in ensuing trajectory. Exenatide versus iGlar reduced bodyweight (-5.4kg; 2.9-7.9; P<0.001), but did not affect blood pressure, lipids or plasma uric acid.Among T2DM patients without overt nephropathy, one-year treatment with exenatide twice-daily does not affect renal function-decline or onset/progression of albuminuria compared to titrated iGlar.ClinicalTrials.gov ID: NCT00097500.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Nyckelord

Albuminuria

urine

Diabetes Mellitus

Type 2

blood

drug therapy

Diabetic Nephropathies

drug therapy

pathology

Exenatide

pharmacology

therapeutic use

Female

Humans

Hypoglycemic Agents

pharmacology

therapeutic use

Insulin Glargine

pharmacology

therapeutic use

Kidney Function Tests

methods

Male

Middle Aged

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