EGFR loss with glucagon-like-peptide-1 (GLP-1) analouge treatment: Data from sustain 6 and leader

ntroduction and Aims Previous SUSTAIN 6 and LEADER cardiovascular (CV) outcomes trials data indicate the GLP-1 analogues semaglutide and liraglutide may have beneficial effects on kidney function. This post hoc analysis investigated the semaglutide and liraglutide effects on change in eGFR evaluated as total eGFR slope. Methods SUSTAIN 6 and LEADER assessed CV, kidney and safety outcomes with semaglutide and liraglutide vs placebo, in 3297 and 9340 patients with type 2 diabetes and at high CV risk, respectively. Median treatment duration was 2.1 and 3.8 years, respectively. In the current analysis, eGFR change over time was evaluated by overall population and baseline eGFR subgroup (<60 vs ≥60 mL/min/1.73 m2) for semaglutide (1.0 mg) and liraglutide vs placebo using a linear regression model with random slope and intercept; treatment differences between annual slopes were estimated (ETDs). Results In the overall population, a slower rate of annual eGFR reduction was observed with semaglutide vs placebo (mean annual ETD of 0.87 mL/min/1.73 m2 favouring semaglutide); this effect appeared more pronounced for baseline eGFR <60 mL/min/1.73 m2, (annual ETD: 1.62 mL/min/1.73 m2 slower eGFR reduction, Table). In LEADER, the annual eGFR reduction was slower for liraglutide vs placebo for the overall population; the effect was more marked in patients with baseline eGFR <60 mL/min/1.73 m2 (annual ETD: 0.67 mL/min/1.73 m2 slower eGFR reduction, Table). Conclusions Annual loss of kidney function was slower in patients treated with semaglutide or liraglutide vs placebo. The benefit appears more pronounced in patients with pre‑existing chronic kidney disease.