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Study: Linagliptin slows albuminuria progression without changing kidney outcomes

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Vlado Perkovic

SAN DIEGO — Patients with type 2 diabetes and chronic kidney disease who received linagliptin showed a slowed progression of albuminuria without changing eGFR or other kidney outcomes, according to data presented at ASN Kidney Week.

“The drug was safe from a cardiovascular prospective,” Vlado Perkovic, MBBS, PhD, FASN, FRACP, of the George Institute for Global Health, said during a press briefing, here. “It did improve glycemic control including people kidney disease, therefore [it] offers an important and safe option for lowering blood glucose in people with reduced GFR and fewer options.”

He said patients with type 2 diabetes and CKD have limited glucose-lowering treatment options. In the CARMELINA trial, a double-blind, randomized control trial, Perkovic and colleagues studied 6,979 patients with type 2 diabetes and prevalent CKD with cardiovascular disease. Patients from 27 countries were followed for a median 2.2 years. Mean age was 66 years.

Patients received 5-mg linagliptin or placebo. The primary cardiovascular endpoint was 3P-MACE, with a key secondary kidney endpoint of adjudicated ESKD, renal death or sustained greater than or equal to 40% decrease in eGFR from baseline. Other renal outcomes included albuminuria and estimated GFR slope.

Perkovic said that overall and in patients with eGFR below 45 mL/min/1.73 m², linagliptin did not increase the risk of cardiovascular events and heart failure and did not affect the risk for sustained eGFR reduction greater than or equal to 40%, ESKD or death due to kidney disease. Patients also showed a significantly reduced risk for progression to albuminuria, had improved glycemic control without increasing hypoglycemia and showed delayed initiation or escalation of insulin. – by Kristine Houck, MA, ELS

Reference:

Perkovic V, et al. Paper FR-OR142. Presented at: ASN Kidney Week; San Diego; Oct. 23-28, 2018.

Disclosure: Perkovic reports commercial support from Boehringer Ingelheim and the Eli Lilly Diabetes Alliance.