SGLT2-Is and MRAs combo associated with lower albuminuria in patients with type 2 DM

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-20T20:00:48+05:30 | Updated On 21 Jan 2023 3:29 PM IST

Combination therapy with SGLT2-Is and MRAs is associated with lower albuminuria in patients with type 2 DM compared to monotherapy with SGLT2-Is or MRAs alone suggests a new study published in Diabetes, Obesity and Metabolism

Diabetes mellitus (DM) is the leading cause of chronic kidney disease. Albuminuria is associated with an increased risk of cardiovascular mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) and mineralocorticoid receptor antagonists (MRAs) protect against albuminuria; however, their combined effects on albuminuria are unclear. We performed a network meta-analysis to investigate the effects of SGLT2-Is, MRAs, and their combination on albuminuria in type 2 DM.

They systematically searched PubMed, Medline, EMBASE, and the Cochrane Library from inception up to November 20, 2022. We selected randomized control and crossover trials that compared MRAs, SGLT2-Is, MRAs + SGLT2-Is, or a placebo in patients with type 2 DM with a urinary albumin-creatinine ratio (UACR) ≥ 30 mg/g creatinine. The primary outcome was the change in the UACR.

Results

• This meta-analysis analyzed 17 studies with 34,412 patients.

• The use of combination treatment with SGLT2-Is and MRAs was associated with lower albuminuria compared to the use of SGLT2-Is, MRAs, or the placebo alone

• Treatment with SGLT2-Is or MRAs alone caused a significant reduction in UACR compared to the placebo

• The effects of MRAs on the UACR are comparable to those of SGLT2-Is. Sensitivity analyses showed similar results.

Combination therapy with SGLT2-Is and MRAs was associated with lower albuminuria in patients with type 2 DM compared to monotherapy with SGLT2-Is or MRAs alone.

Reference:

Morita, R., Tsukamoto, S., Obata, S., Yamada, T., Uneda, K., Uehara, T., Rehman, M.E., Azushima, K., Wakui, H. and Tamura, K. (2023), Effects of sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists, and their combination on albuminuria in diabetic patients. Diabetes Obes Metab. Accepted Author Manuscript. https://doi.org/10.1111/dom.14976

Keywords:

Diabetes, Obesity and Metabolism, Morita, R., Tsukamoto, S., Obata, S., Yamada, T., Uneda, K., Uehara, T., Rehman, M.E., Azushima, K., Wakui, H. and Tamura, K, Effects, sodium-glucose, cotransporter 2 inhibitors, mineralocorticoid, receptor antagonists, combination, albuminuria, diabetic patients.

DiabetesObesity and Metabolismtype 2 DMCombination therapyalbuminuria

Source : Diabetes, Obesity and Metabolism

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751