Influence of Combination Therapy with Dulaglutide or Liraglutide and SGLT2 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Post-hoc Analysis of the RECAP Study.

Q3 Medicine Tokai Journal of Experimental and Clinical Medicine Pub Date : 2025-04-20

Yoshimi Muta, Kazuo Kobayashi, Masao Toyoda, Shunichiro Tsukamoto, Daisuke Tsuriya, Yuichi Takashi, Hisashi Yokomizo, Kei Takeshita, Takuya Hashimoto, Moritsugu Kimura, Kouichi Tamura, Keizo Kanasaki, Daiji Kawanami

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Abstract

Objective: We report that the effect of combination therapy with SGLT2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1Ra) on renal composite outcomes is not affected by the preceding drug in patients with type 2 diabetes (T2D). In this study, we performed a post-hoc analysis of dulaglutide and liraglutide users and investigated the differences between GLP1Ra.

Methods: We analyzed 266 patients treated with an SGLT2i followed by dulaglutide or liraglutide and 194 treated with dulaglutide or liraglutide followed by an SGLT2i. In addition, we analyzed dulaglutide users (n = 246) and liraglutide users (n = 214). Renal composite outcome was defined as the progression of albuminuria and/or a ≥ 30% eGFR decline.

Results: The incidence of renal composite outcomes in the SGLT2i-preceding and GLP1Ra (dulaglutide or liraglutide)-preceding groups was not significantly different. It also did not differ between the dulaglutide and liraglutide users. The incidence of ≥ 30% eGFR decline was more frequent in liraglutide users, with an odds ratio of 2.63 (95% confidence interval: 1.07-6.45, p = 0.04), with a significantly larger decrease in albuminuria in liraglutide users, with an odds ratio of 0.44 (95% confidence interval: 0.04-0.85, p = 0.03).

Conclusions: Dulaglutide and liraglutide may have different effects on albuminuria and the kidney function in combination with SGLT2i.

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杜拉鲁肽或利拉鲁肽与SGLT2抑制剂联合治疗对2型糖尿病患者肾脏预后的影响：RECAP研究的事后分析

目的：我们报道SGLT2抑制剂（SGLT2i）和胰高血糖素样肽-1受体激动剂（GLP1Ra）联合治疗对2型糖尿病（T2D）患者肾脏综合预后的影响不受前一种药物的影响。在这项研究中，我们对杜拉鲁肽和利拉鲁肽使用者进行了事后分析，并调查了GLP1Ra之间的差异。方法：我们分析了266例SGLT2i治疗后使用杜拉鲁肽或利拉鲁肽，194例杜拉鲁肽或利拉鲁肽治疗后使用SGLT2i。此外，我们还分析了杜拉鲁肽使用者（n = 246）和利拉鲁肽使用者（n = 214）。肾脏综合结局定义为蛋白尿进展和/或eGFR下降≥30%。结果：sgltti前用药组和GLP1Ra（杜拉鲁肽或利拉鲁肽）前用药组的肾脏综合结局发生率无显著差异。在杜拉鲁肽和利拉鲁肽使用者之间也没有差异。利拉鲁肽服用者eGFR下降≥30%的发生率更高，比值比为2.63(95%可信区间：1.07-6.45,p = 0.04)，利拉鲁肽服用者蛋白尿下降幅度更大，比值比为0.44（95%可信区间：0.04-0.85,p = 0.03）。结论：杜拉鲁肽和利拉鲁肽联合SGLT2i对蛋白尿和肾功能的影响可能不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tokai Journal of Experimental and Clinical Medicine Medicine-Medicine (all)

CiteScore

1.10

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0.00%

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期刊介绍： The Tokai Journal of Experimental and Clinical Medicine, also referred to as Tokai Journal, is an official quarterly publication of the Tokai Medical Association. Tokai Journal publishes original articles that deal with issues of clinical, experimental, socioeconomic, cultural and/or historical importance to medical science and related fields. Manuscripts may be submitted as full-length Original Articles or Brief Communications. Tokai Journal also publishes reviews and symposium proceedings. Articles accepted for publication in Tokai Journal cannot be reproduced elsewhere without written permission from the Tokai Medical Association. In addition, Tokai Journal will not be held responsible for the opinions of the authors expressed in the published articles.