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Liraglutide reduces adverse renal outcomes
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Liraglutide was effective in reducing the risk for new-onset persistent macroalbuminuria, acute kidney injury and death due to renal disease in adults with type 2 diabetes and high cardiovascular risk, according to results from a secondary analysis of the LEADER trial.
Johannes F.E. Mann, MD, professor of medicine at Friedrich Alexander University of Erlangen-Nürnberg in Germany, and colleagues evaluated data from the LEADER trial on 9,340 adults (mean age, 64 years) with type 2 diabetes and high CV risk randomly assigned to liraglutide (Victoza, Novo Nordisk; n = 4,668) or placebo (n = 4,672) to determine the long-term effects of liraglutide on renal outcomes. The primary composite renal outcome included new-onset persistent macroalbuminuria, persistent doubling of serum creatinine level, renal-replacement therapy and death due to renal disease. Median follow-up was 3.84 years.
At randomization, microalbuminuria was present in 26.3% of participants and macroalbuminuria in 10.5%.
Fewer participants in the liraglutide group experienced the prespecified renal outcome compared with those in the placebo group (5.7% vs. 7.2%; HR = 0.78; 95% CI, 0.67-0.92). More participants in the placebo group experienced new-onset persistent macroalbuminuria compared with those in the liraglutide group (4.6% vs. 3.4%; HR = 0.74; 95% CI, 0.6-0.91). No significant differences in persistent doubling of the serum creatinine level or end-stage renal disease were observed between the two groups. Death was uncommon in the groups: eight in the liraglutide group vs. five in the placebo group.
Among the subgroup of participants with microalbuminuria or macroalbuminuria, participants in the liraglutide group were less likely to experience the composite renal outcome compared with those in the placebo group (13.7% vs. 16.3%; HR = 0.81; 95% CI, 0.68-0.96).
In the subgroup of participants with estimated glomerular filtration rate (eGFR) less than 60 mL per minute per 1.73 m2, participants in the liraglutide group were less likely to experience the composite renal outcome compared with the placebo group (13.1% vs. 15%; HR = 0.84; 95% CI, 0.67-1.05).
Similar rates of renal adverse events were observed between the two groups (liraglutide, 1.1 events per 1,000 patient-years vs. placebo, 16.5 events); the same was true for the rate of acute kidney injury (liraglutide, 7.1 events vs. placebo, 6.2 events).
“In this secondary analysis, among patients with type 2 diabetes at high risk for cardiovascular disease who were receiving usual care, liraglutide resulted in a lower risk of the composite renal outcome than placebo, primarily owing to a lower rate of new-onset persistent macroalbuminuria,” the researchers wrote. – by Amber Cox
Disclosures: Mann reports he receives grant support from the European Union and McMaster University; grant support and personal fees from AbbVie, Celgene, Novo Nordisk, Sandoz and Roche; and personal fees from AstraZeneca, Amgen, ACI Clinical, Fresenius, Gambro, Lanthio Pharma, MEDICE, Novo Nordisk, Relypsa, Sanifit and ZS pharma. Please see the study for a list of all other authors’ relevant financial disclosures.
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