Table 3.
Summary of renal outcomes in RWS with GLP-1RA vs. other GLD (including SGLT-2i).
| Boye et al. | Boye et al. | Lugner et al. | Pasternak et al. | ||
|---|---|---|---|---|---|
| Main Baseline Features | N | 5932 | 2366 | 21,781 | 77,462 |
| GLP-1RA | - | Dulaglutide | 75.1% Liraglutide 16.3% Dulaglutide 6.4% Exenatide QW |
92.5% Liraglutide 6.2% Exenatide 0.7% Lixisenatide 0.6% Dulaglutide |
|
| Comparator | Other GLD | Insulin Glargine | SGLT-2i (56.6% Empagliflozin 43.2% Dapagliflozin 0.2% Canagliflozin) |
DPP-4i | |
| Follow-up (yrs) | 1 | 1 | 1.7–1.1 | 3.0 | |
| Mean age (yrs) | 59.2 | 59.7 | 60.5 | 59.3 | |
| Female (%) | 52.0 | 51.1 | 37.5 | 40.7 | |
| Mean diabetes duration (yrs) | - | - | 7.5 | - | |
| Mean HbA1c (%) | 8.4 | 8.3 | 8.3 | - | |
| Mean eGFR (mL/min/1.73 m2) | 82.1 | 83.7 | 91.6 | - | |
| eGFR <60 mL/min/1.73 m2 (%) | 19.4 | 18.2 | - | 4.6 | |
| Mean albuminuria (mg/L) | - | - | - | - | |
| Microalbuminuria (%) | - | - | 20.6 | - | |
| Macroalbuminuria (%) | - | - | 4.3 | - | |
| Renal Outcomes | Change in albuminuria (mean (95% CI)) |
- | - | - | - |
| New onset MA (HR (95% CI)) |
- | - | 0.89 (0.77–1.04) | - | |
| Change in eGFR (mL/min/1.73 m2) |
−0.80 vs. −1.03
p = 0.0005 |
−0.4 vs. −0.9
p = 0.0024 |
- | - | |
| ≥30% eGFR reduction |
2.19% vs. 3.14%
p < 0.0001 |
3.3% vs 4.1%;
p < 0.0001 |
0.92 (0.68–1.25) § | - | |
| ≥40% eGFR reduction (HR (95% CI)) # |
- | - | 0.94 (0.62–1.43) | - | |
| Composite renal Outcome * (HR (95% CI)) # |
- | - | 0.98 (0.92–1.05) | 0.76 (0.68–0.85)/0.60 (0.49–0.74) | |
| Renal replacement therapy (HR (95% CI)) # |
- | - | - | 0.73 (0.62–0.87)/0.42 (0.29–0.62) | |
| Hospitalization for renal events (HR (95% CI)) # | - | - | - | 0.73 (0.65–0.83)/0.63 (0.50–0.78) | |
| Renal death (HR (95% CI)) # |
- | - | - | 0.72 (0.48–1.10)/0.66 (0.24–1.49) |
GLP-1RA, glucagon-like peptide-1 receptor agonists; SGLT-2i, sodium-glucose cotransporter-2; GLD, glucose lowering drugs; DPP-4i, dipeptidyl peptidase-4 inhibitors; MA, macroalbuminuria. Statistically significant results are in bold. § HR (95% CI). # Results are presented as intention-to-treat/as-treated analyses. * Lugner et al.: any of micro- or macroalbuminuria, eGFR 50% reduction or lower than 60, dialysis, renal transplantation, renal failure, renal death; Pasternak et al.: renal replacement therapy, hospitalization for renal causes and death for renal causes.