Renoprotective Effects of Combination Treatment with Sodium-glucose Cotransporter Inhibitors and GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus According to Preceding Medication

Kobayashi, Kazuo; Toyoda, Masao; Tone, Atsuhito; Kawanami, Daiji; Suzuki, Daisuke; Tsuriya, Daisuke; Machimura, Hideo; Shimura, Hidetoshi; Takeda, Hiroshi; Yokomizo, Hisashi; Takeshita, Kei; Chin, Keiichi; Kanasaki, Keizo; Miyauchi, Masaaki; Saburi, Masuo; Morita, Miwa; Yomota, Miwako; Kimura, Moritsugu; Hatori, Nobuo; Nakajima, Shinichi; Ito, Shun; Tsukamoto, Shunichiro; Murata, Takashi; Matsushita, Takaya; Furuki, Takayuki; Hahimoto, Takuya; Umezono, Tomoya; Muta, Yoshimi; Takashi, Yuichi; Tamura, Kouichi

doi:10.51094/jxiv.425

##article.authors##

Kobayashi, Kazuo Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
Toyoda, Masao Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine
Tone, Atsuhito Department of Internal Medicine, Diabetes Center, Okayama Saiseikai General Hospital
Kawanami, Daiji Department of Endocrinology and Diabetes Mellitus, Fukuoka University School of Medicine
Suzuki, Daisuke Suzuki diabetes clinic
Tsuriya, Daisuke 2nd Department of Internal Medicine, Hamamatsu University School of Medicine
Machimura, Hideo Machimura internal medicine clinic
Shimura, Hidetoshi Shimura clinic
Takeda, Hiroshi Takeda clinic
Yokomizo, Hisashi Department of Endocrinology and Diabetes Mellitus, Fukuoka University School of Medicine
Takeshita, Kei 2nd Department of Internal Medicine, Hamamatsu University School of Medicine
Chin, Keiichi Hakuai clinic
Kanasaki, Keizo Department of Internal Medicine 1, Endocrinology and Metabolism, Shimane University Faculty of Medicine
Miyauchi, Masaaki Miyauchi diabetes clinic
Saburi, Masuo Department of Diabetology, Endocrinology and Metabolism, Tokyo Medical University Hachioji Medical Center
Morita, Miwa Department of Internal Medicine 1, Endocrinology and Metabolism, Shimane University Faculty of Medicine
Yomota, Miwako Department of Internal Medicine 1, Endocrinology and Metabolism, Shimane University Faculty of Medicine
Kimura, Moritsugu Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine
Hatori, Nobuo Kobayashi Hospital
Nakajima, Shinichi Sagami Junkanki clinic
Ito, Shun Department of Internal Medicine, Sagamihara Red Cross Hospital
Tsukamoto, Shunichiro Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
Murata, Takashi Department of Clinical Nutrition, National Hospital Organization Kyoto Medical Center
Matsushita, Takaya Department of Diabetology, Endocrinology and Metabolism, Tokyo Medical University Hachioji Medical Center
Furuki, Takayuki Hadano station south-gate clinic
Hahimoto, Takuya 2nd Department of Internal Medicine, Hamamatsu University School of Medicine
Umezono, Tomoya Umezono internal medicine clinic
Muta, Yoshimi Department of Endocrinology and Diabetes Mellitus, Fukuoka University School of Medicine
Takashi, Yuichi Department of Endocrinology and Diabetes Mellitus, Fukuoka University School of Medicine
Tamura, Kouichi Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine

DOI:

https://doi.org/10.51094/jxiv.425

キーワード:

sodium-glucose cotransporter 2 inhibitors、 glucagon-like peptide 1 receptor agonist、 renal outcome、 combination treatment、 preceding drug

抄録

Aims: Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice for type 2 diabetes mellitus (T2DM) management. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice.

Methods: We retrospectively extracted T2DM patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year at 18 medical facilities in Japan. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. The multiple imputation method and the analysis using propensity score was performed for the comparison of the renal composite outcome.

Results: The incidences of the renal composite outcome in the SGLT2i- and GLP1Ra-preceding groups was 28% and 25%, respectively, with an odds ratio (OR) [95%CI] of 1.14 [0.75, 1.73] (P=0.54).Compared to the GLP1Ra-preceding group, the annual change in the eGFR as well as the change in the logarithmic value of the urine albumin-to-creatinine ratio of patients in the SGLT2i-precedig group were 0.3 mL/min/1.73 m2/year [-0.3,1.0, p=0.35], and 0.20 [-0.06, 0.47, p=0.14], respectively.

Conclusion: With combination therapy of SGLT2i and GLP1Ra, the preceding drug might not affect the renal outcome.

利益相反に関する開示

The authors declare no conflicts of interest in association with the present study.

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