Renoprotective Effects of Combination Treatment with Sodium-glucose Cotransporter Inhibitors and GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus According to Preceding Medication

Overview

Journal Diab Vasc Dis Res

Publisher Sage Publications

Specialty Cardiology & Vascular Diseases

Date 2023 Dec 14

PMID 38096503

Authors

Kazuo Kobayashi

Masao Toyoda

Atsuhito Tone

Daiji Kawanami

Daisuke Suzuki

Daisuke Tsuriya

Hideo Machimura

Hidetoshi Shimura

Hiroshi Takeda

Hisashi Yokomizo

Kei Takeshita

Keiichi Chin

Keizo Kanasaki

Masaaki Miyauchi

Masuo Saburi

Miwa Morita

Miwako Yomota

Moritsugu Kimura

Nobuo Hatori

Shinichi Nakajima

Shun Ito

Shunichiro Tsukamoto

Takashi Murata

Takaya Matsushita

Takayuki Furuki

Takuya Hashimoto

Tomoya Umezono

Yoshimi Muta

Yuichi Takashi

Kouichi Tamura

Affiliations

Soon will be listed here.

Abstract

Aims: Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice.

Methods: We retrospectively extracted type 2 diabetes mellitus patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. Either progression of the albuminuria status and/or a ≥30% decrease in the eGFR was set as the primary renal composite outcome. The analysis using propensity score with inverse probability weighting was performed for the outcome.

Results: The incidences of the renal composite outcome in the SGLT2i- and GLP1Ra-preceding groups were 28% and 25%, respectively, with an odds ratio [95% confidence interval] of 1.14 [0.75, 1.73] ( = .54). A logistic regression analysis showed that the mean arterial pressure (MAP) at baseline, the logarithmic value of the urine albumin-to-creatinine ratio at baseline, and the change in MAP were independent factors influencing the renal composite outcome.

Conclusion: With combination therapy of SGLT2i and GLP1Ra, the preceding drug did not affect the renal outcome.

Citing Articles

Influence of the combination of SGLT2 inhibitors and GLP-1 receptor agonists on eGFR decline in type 2 diabetes: post-hoc analysis of RECAP study.

Muta Y, Kobayashi K, Toyoda M, Tone A, Suzuki D, Tsuriya D Front Pharmacol. 2024; 15:1358573.

PMID: 38601470 PMC: 11005912. DOI: 10.3389/fphar.2024.1358573.

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