Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial.

ABSTRACT: The effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on renal outcomes in patients with type 2 diabetes at high cardiovascular risk are modest or neutral. However, GLP-1RAs may confer clinical benefits in those at high risk of progressive renal function loss. We examined the effects of once-weekly exenatide (EQW) on estimated glomerular filtration rate (eGFR) slope and urinary albumin:creatinine ratio (UACR) as a function of baseline UACR in 3503 EXSCEL participants (23.7%) with eGFR data available and 2828 participants (19.2%) with UACR change data available. EQW improved eGFR slope assessed via mixed model repeated measures, compared with placebo, in participants with baseline UACR?>100?mg/g (0.79?mL/min/1.73?m² /year [95% confidence interval {CI} 0.24-1.34]) and UACR >200?mg/g (1.32?mL/min/1.73?m² /year [95% CI 0.57-2.06]), but not at lower UACR thresholds. EQW reduced UACR, compared with placebo, assessed via analysis of covariance, consistently across subgroups with baseline UACR?>30?mg/g (28.2% reduction), baseline UACR?>100?mg (22.5% reduction) and baseline UACR?>200?mg (34.5% reduction). This post hoc EXSCEL analysis suggests that EQW reduces UACR, with improvement in eGFR slope specifically in participants with elevated baseline UACR.

SUBMITTER: van der Aart-van der Beek AB 

PROVIDER: S-EPMC7756541 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature