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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

##article.authors##

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

DOI:

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

Keywords:

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

Abstract

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.

Conflicts of Interest Disclosure

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

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Posted


Submitted: 2023-06-24 14:39:30 UTC

Published: 2023-06-29 05:31:10 UTC
Section
Clinical Medicine