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Liraglutide and Renal Outcomes in T2D Patients

N Engl J Med; 2017 Aug 31; Mann, et al

When added to usual care in patients with type 2 diabetes (T2D), liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo, a recent study found. The prespecified secondary analysis of a randomized controlled trial compared liraglutide with placebo in patients with T2D and high cardiovascular risk. A total of 9,340 patients underwent randomization with median follow-up of 3.84 years. Researchers found:

  • The renal outcomes occurred in fewer participants in the liraglutide group vs the placebo group (HR, 0.78).
  • The result was driven primarily by the new onset on persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group.
  • The rates of renal adverse events were similar between the 2 groups.

Citation:

Mann JFE, Ørsted DD, Brown-Frandsen K, et al. Liraglutide and renal outcomes in type 2 diabetes. N Engl J Med. 2017;377:839-848. doi:10.1056/NEJMoa1616011.

Commentary:

It is important to keep up with the wealth of evidence being discovered for some of the new classes of diabetes medications in decreasing complications of diabetes. Two classes of medications, SGLT-2s and GLP-1 receptor agonists, have now been shown to decrease major adverse cardiovascular events in patients with diabetes and established cardiovascular disease.1,2 Now, these same 2 classes of medications have also been shown to decrease development and progression of diabetic kidney disease.3 In both cases, the results have been shown in studies lasting from 3 to 5 years, effects that in the past were only hoped for, not expected. —Neil Skolnik, MD

  1. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311-322. doi:10.1056/NEJMoa1603827.
  2. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117-2128. doi:10.1056/NEJMoa1504720.
  3. Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and progression of kidney disease in type 2 diabetes. N Engl J Med. 2016;375:323-334. doi:10.1056/NEJMoa1515920.