Exenatide Shows Efficacy in Improving Renal Outcomes in T2D

Renal Function Blood Test Order
Renal Function Blood Test Order
Investigators examined the effect of exenatide on estimated glomerular filtration rate, new macroalbuminuria, and 2 renal composites.
The following article is part of conference coverage from the American Diabetes Association’s 78th Scientific Sessions (ADA 2018) in Orlando,Florida. Endocrinology Advisor’s staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back for the latest news from ADA 2018.

ORLANDO — Exenatide has shown efficacy in reducing estimated glomerular filtration rate (eGFR) decline, renal death, renal replacement, and new macroalbuminuria in individuals with type 2 diabetes. This research was recently presented at the American Diabetes Association’s 78th Scientific Sessions held in Orlando, Florida, June 22 – 26, 2018.

This study was multinational and investigated the impact of exenatide on eGFR, 2 combined renal figures from a predetermined analysis procedure, and new macroalbuminuria. The study researchers collected relevant laboratory data and evaluated overall least squares mean difference eGFR for all participants at baseline, with at least 1 additional figure collected in follow-up. A Cox regression model was used to evaluate the outcome on new macroalbuminuria. Interval-censored time to event models, both adjusted and unadjusted for disease and demographic baseline characteristics, were used to estimate outcomes on renal composites.

This randomized, placebo-controlled, blinded study included 13,844 participants randomly assigned to placebo or exenatide once per week plus normal care. The exenatide group showed no significant differences in levels of eGFR (least squares mean difference +0.21 [-0.27-0.70] mL/min; 1.73 m2; P =.39). New macroalbuminuria occurred in 2.2% in the exenatide group, and 2.5% of the placebo group (P =.19). The renal composite 2 adjusted risk was 15% lower with exenatide (P =.027). 

The study researchers conclude that “[a] composite of 40% eGFR decline, renal replacement, renal death or new macroalbuminuria was significantly reduced in an adjusted analysis by the addition of exenatide in a broad range of people with type 2 diabetes. Other renal outcomes were numerically but not statistically improved with exenatide.”

This study was supported by AstraZeneca. Please refer to reference for a complete list of authors’ disclosures.

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Holman RR, Bethel MA, Mentz RJ, et al. Renal outcomes in the EXenatide Study of Cardiovascular Event Lowering (EXSCEL). Poster presentation at: ADA 2018 78th Scientific Sessions; June 22-26, 2018; Orlando, FL. Poster 522.