Dulaglutide may prevent diabetic kidney disease in patients with type 2 diabetes

For this purpose, the researchers performed intent-to-treat analyses on REWIND participants (n = 4,949 DU, n = 4,952 placebo). They examined the time to occurrence of a composite kidney function-related outcome.

Time to occurrence of a composite kidney function–related outcome (≥40% sustained decline in eGFR, per the Chronic Kidney Disease Epidemiology Collaboration 2009 equation, renal-related death, or end-stage renal disease), and mean annual eGFR slope. Analyses were conducted overall and within subgroups defined by baseline UACR (urinary albumin-to-creatinine ratio <30 or ≥30 mg/g) and baseline eGFR (<60 or ≥60 mL/min/1.73 m2).

The authors reported the following findings:

• The post hoc composite kidney function–related outcome occurred less frequently among participants assigned to DU than placebo (hazard ratio [HR] 0.75), with no evidence of a differential DU treatment effect by UACR or eGFR subgroup.
• A ≥40% sustained eGFR decline occurred less frequently among participants assigned to DU than placebo (HR 0.72).
• The mean annual decline in eGFR slope was significantly smaller for participants assigned to DU than placebo (−1.37 versus −1.56 mL/min/1.73 m2/year); all subgroups had similar results.

Dulaglutide was associated with a 25% reduced hazard of the composite kidney function-related outcome compared with a placebo.

"Our post hoc analyses suggest that 1.5 mg dulaglutide could provide renal benefits to adults with type 2 diabetes at risk of cardiovascular disease and with varying renal function," the authors concluded.

Reference:

Fady T. Botros, Hertzel C. Gerstein, Raleigh Malik, Claudia Nicolay, Anastasia Hoover, Ibrahim Turfanda, Helen M. Colhoun, Jonathan E. Shaw; Dulaglutide and Kidney Function–Related Outcomes in Type 2 Diabetes: A REWIND Post Hoc Analysis. Diabetes Care 2023; dc230231. https://doi.org/10.2337/dc23-0231