دورية أكاديمية
Kidney function loss and albuminuria progression with GLP-1 receptor agonists versus basal insulin in patients with type 2 diabetes:real-world evidence
| العنوان: | Kidney function loss and albuminuria progression with GLP-1 receptor agonists versus basal insulin in patients with type 2 diabetes:real-world evidence |
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| المؤلفون: | Schechter, Meir, Melzer Cohen, Cheli, Fishkin, Alisa, Rozenberg, Aliza, Yanuv, Ilan, Sehtman-Shachar, Dvora R., Chodick, Gabriel, Clark, Alice, Abrahamsen, Trine J., Lawson, Jack, Karasik, Avraham, Mosenzon, Ofri |
| المصدر: | Schechter , M , Melzer Cohen , C , Fishkin , A , Rozenberg , A , Yanuv , I , Sehtman-Shachar , D R , Chodick , G , Clark , A , Abrahamsen , T J , Lawson , J , Karasik , A & Mosenzon , O 2023 , ' Kidney function loss and albuminuria progression with GLP-1 receptor agonists versus basal insulin in patients with type 2 diabetes : real-world evidence ' , Cardiovascular Diabetology , vol. 22 , 126 . https://doi.org/10.1186/s12933-023-01829-0Test |
| سنة النشر: | 2023 |
| المجموعة: | University of Groningen research database |
| مصطلحات موضوعية: | Albuminuria, Basal insulin, Chronic kidney disease, eGFR slope, GLP-1 RA, Real world, Real world evidence, Type 2 diabetes |
| الوصف: | Background: In clinical trials enrolling patients with type 2 diabetes (T2D) at high cardiovascular risk, many glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improved albuminuria status and possibly mitigated kidney function loss. However, limited data are available regarding the effects of GLP-1 RAs on albuminuria status and kidney function in real-world settings, including populations with a lower baseline cardiovascular and kidney risk. We assessed the association of GLP-1 RAs initiation with long-term kidney outcomes in the Maccabi Healthcare Services database, Israel. Methods: Adults with T2D treated with ≥ 2 glucose-lowering agents who initiated GLP-1 RAs or basal insulin from 2010 to 2019 were propensity-score matched (1:1) and followed until October 2021 (intention-to-treat [ITT]). In an as-treated (AT) analysis, follow-up was also censored at study-drug discontinuation or comparator-initiation. We assessed the risk of a composite kidney outcome, including confirmed ≥ 40% eGFR loss or end-stage kidney disease, and the risk of new macroalbuminuria. Treatment-effect on eGFR slopes was assessed by fitting a linear regression model per patient, followed by a t-test to compare the slopes between the groups. Results: Each propensity-score matched group constituted 3424 patients, 45% women, 21% had a history of cardiovascular disease, and 13.9% were treated with sodium-glucose cotransporter-2 inhibitors at baseline. Mean eGFR was 90.6 mL/min/1.73 m 2 (SD 19.3) and median UACR was 14.6 mg/g [IQR 0.0–54.7]. Medians follow-up were 81.1 months (ITT) and 22.3 months (AT). The hazard-ratios [95% CI] of the composite kidney outcome with GLP-1 RAs versus basal insulin were 0.96 [0.82–1.11] (p = 0.566) and 0.71 [0.54–0.95] (p = 0.020) in the ITT and AT analyses, respectively. The respective HRs for first new macroalbuminuria were 0.87 [0.75–0.997] and 0.80 [0.64–0.995]. The use of GLP-1 RA was associated with a less steep eGFR slope compared with basal insulin in the AT analysis (mean annual between-group ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://research.rug.nl/en/publications/70d3dbbb-b390-4e97-b3e3-a4e7d1433efbTest |
| DOI: | 10.1186/s12933-023-01829-0 |
| الإتاحة: | https://doi.org/10.1186/s12933-023-01829-0Test https://hdl.handle.net/11370/70d3dbbb-b390-4e97-b3e3-a4e7d1433efbTest https://research.rug.nl/en/publications/70d3dbbb-b390-4e97-b3e3-a4e7d1433efbTest https://pure.rug.nl/ws/files/781653250/s12933-023-01829-0.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.A57B9E4B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s12933-023-01829-0 |
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