Effects of incretin-based therapeutic agents including tirzepatide on renal outcomes in patients with type 2 diabetes: A systemic review and meta-analysis

Metabolism open Pub Date : 2023-03-01 DOI:10.1016/j.metop.2023.100236

Akira Mima, Hidemasa Gotoda, Rina Lee, Ami Murakami, Ryosuke Akai, Shinji Lee

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引用次数: 2

Abstract

Background

This meta-analysis was conducted to investigate the effects of incretin-based therapeutic agents, including the latest agent tirzepatide, on renal outcomes in patients with type 2 diabetes.

Methods

MEDLINE (via PubMed) and Cochrane databases were searched for studies involving incretin-based therapeutic agents up to July 2022. Randomized and controlled trials comparing incretin-based therapeutic agents with placebo or other antidiabetic agents, and reporting renal outcomes were selected. The inclusion criteria were items related to the effects on albuminuria and the kidney-specific composite outcomes. A network meta-analysis was conducted to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

Twelve trials consisting of 75,346 participants were included in this meta-analysis. Glucagon-like peptide-1 (GLP-1) receptor agonists reduced the risk of the kidney-specific composite outcome by 21% (HR 0.79, 95% CI 0.75–0.85), and worsening albuminuria by 24% (HR 0.76, 95% CI 0.71–0.82). In particular, the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide remarkably reduced the risk of the kidney-specific composite outcome by 45% (HR 0.55, 95% CI 0.40–0.77), and worsening albuminuria by 62% (HR 0.38, 95% CI 0.24–0.61).

Conclusions

Among incretin-based therapeutic agents, tirzepatide was associated with a significantly reduced risk of diabetic kidney disease.

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肠促胰岛素治疗剂包括替西帕肽对2型糖尿病患者肾脏预后的影响：一项系统综述和荟萃分析

背景本荟萃分析旨在研究以肠促胰岛素为基础的治疗药物，包括最新的替西帕肽，对2型糖尿病患者肾脏预后的影响。方法检索MEDLINE（通过PubMed）和Cochrane数据库中截至2022年7月涉及肠促胰岛素治疗剂的研究。选择了随机和对照试验，将肠促胰岛素治疗剂与安慰剂或其他抗糖尿病药物进行比较，并报告肾脏结果。纳入标准是与对蛋白尿的影响和肾脏特异性复合结果相关的项目。采用网络荟萃分析方法计算危险比（HR）和95%置信区间（CI）。胰高血糖素样肽-1（GLP-1）受体激动剂可将肾脏特异性复合结果的风险降低21%（HR 0.79，95%CI 0.75–0.85），并将蛋白尿恶化的风险降低24%（HR 0.76，95%CI 0.71–0.82）。特别是，双葡萄糖依赖性促胰岛素多肽（GIP）/GLP-1受体激动剂替西帕肽显著降低肾特异性复合结局的风险45%（HR 0.55，95%CI 0.40–0.77），并降低蛋白尿恶化的风险62%（HR 0.38，95%CI 0.24–0.61），替西帕肽与糖尿病肾病的风险显著降低相关。

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来源期刊

Metabolism open Agricultural and Biological Sciences (General), Endocrinology, Endocrinology, Diabetes and Metabolism

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40 days