In a nutshell
This study examined if long-term dulaglutide (Trulicity) treatment could reduce kidney disease symptoms in patients with Type 2 diabetes (T2D). The authors concluded that dulaglutide improved some symptoms of kidney disease over five years compared to placebo.
Some background
T2D often leads to long-term health complications, such as kidney disease (KD). About 40% of patients with diabetes have KD. If left untreated, this condition can lead to other conditions such as heart disease and kidney failure. Previous studies have shown that certain anti-diabetes medications can also help improve kidney problems.
Dulaglutide is a GLP-1 receptor antagonist. This treatment helps the pancreas release the right amount of insulin when blood glucose levels are high. Dulaglutide can lower blood sugar levels and reduce the risk of heart disease in patients with T2D. However, whether dulaglutide can also help reduce symptoms of KD is unknown.
Methods & findings
This study included 9901 patients with T2D. 4949 patients received dulaglutide, and 4952 patients received a placebo. 9.1% (dulaglutide) and 8.9% (placebo) of patients had symptoms of KD at the beginning of the study. Patients were followed-up for an average of 5.4 years.
During follow-up, 17.1% (dulaglutide) and 19.6% (placebo) of patients developed symptoms of KD. Dulaglutide was significantly associated with a 15% lower risk of developing KD compared to placebo.
One symptom of KD is macroalbuminuria. This means that there is a high amount of albumin protein in the urine. High albumin in the urine increases the risk of kidney disease progressing to kidney failure. 8.9% (dulaglutide) versus 11.3% (placebo) of patients developed macroalbuminuria. Dulaglutide was significantly associated with a 23% lower risk of macroalbuminuria compared to placebo.
Kidney blood filtration is a measurement of kidney function. 10.0% (dulaglutide) versus 13.1% (placebo) of patients had a decline of 50% or more in the ability of the kidneys to filter blood. Dulaglutide was significantly associated with a 44% lower risk of poor filtration function compared to placebo.
Renal replacement therapy (RRT) is used to help patients with kidney failure. This therapy replaces the normal blood-filtering function of the kidneys. Dulaglutide was associated with a 25% lower risk of needing RRT compared to placebo.
The bottom line
This study concluded that dulaglutide helped reduce some symptoms of kidney disease. The authors suggest that long-term dulaglutide treatment may help slow down the progression of kidney disease.
The fine print
This study looked back in time to analyze data. Patients were selected to participate in the original study based on age and heart disease risk. This may bias the results. Also, this study was funded by Eli Lilly, the manufacturer of dulaglutide.
What’s next?
Talk to your doctor about treatments that may help reduce your risk of T2D complications.
Published By :
Lancet (London, England)
Date :
Jun 07, 2019
