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Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial.

Publication ,  Journal Article
van der Aart-van der Beek, AB; Clegg, LE; Penland, RC; Boulton, DW; Sjöström, CD; Mentz, RJ; Holman, RR; Heerspink, HJL
Published in: Diabetes Obes Metab
December 2020

The effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on renal outcomes in patients with type 2 diabetes at high cardiovascular risk are modest or neutral. However, GLP-1RAs may confer clinical benefits in those at high risk of progressive renal function loss. We examined the effects of once-weekly exenatide (EQW) on estimated glomerular filtration rate (eGFR) slope and urinary albumin:creatinine ratio (UACR) as a function of baseline UACR in 3503 EXSCEL participants (23.7%) with eGFR data available and 2828 participants (19.2%) with UACR change data available. EQW improved eGFR slope assessed via mixed model repeated measures, compared with placebo, in participants with baseline UACR >100 mg/g (0.79 mL/min/1.73 m2 /year [95% confidence interval {CI} 0.24-1.34]) and UACR >200 mg/g (1.32 mL/min/1.73 m2 /year [95% CI 0.57-2.06]), but not at lower UACR thresholds. EQW reduced UACR, compared with placebo, assessed via analysis of covariance, consistently across subgroups with baseline UACR >30 mg/g (28.2% reduction), baseline UACR >100 mg (22.5% reduction) and baseline UACR >200 mg (34.5% reduction). This post hoc EXSCEL analysis suggests that EQW reduces UACR, with improvement in eGFR slope specifically in participants with elevated baseline UACR.

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Published In

Diabetes Obes Metab

DOI

EISSN

1463-1326

Publication Date

December 2020

Volume

22

Issue

12

Start / End Page

2493 / 2498

Location

England

Related Subject Headings

  • Kidney Function Tests
  • Kidney
  • Humans
  • Glomerular Filtration Rate
  • Exenatide
  • Endocrinology & Metabolism
  • Diabetes Mellitus, Type 2
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Chicago
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van der Aart-van der Beek, A. B., Clegg, L. E., Penland, R. C., Boulton, D. W., Sjöström, C. D., Mentz, R. J., … Heerspink, H. J. L. (2020). Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial. Diabetes Obes Metab, 22(12), 2493–2498. https://doi.org/10.1111/dom.14175
Aart-van der Beek, Annemarie B. van der, Lindsay E. Clegg, Robert C. Penland, David W. Boulton, C David Sjöström, Robert J. Mentz, Rury R. Holman, and Hiddo J. L. Heerspink. “Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial.Diabetes Obes Metab 22, no. 12 (December 2020): 2493–98. https://doi.org/10.1111/dom.14175.
van der Aart-van der Beek AB, Clegg LE, Penland RC, Boulton DW, Sjöström CD, Mentz RJ, et al. Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial. Diabetes Obes Metab. 2020 Dec;22(12):2493–8.
van der Aart-van der Beek, Annemarie B., et al. “Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial.Diabetes Obes Metab, vol. 22, no. 12, Dec. 2020, pp. 2493–98. Pubmed, doi:10.1111/dom.14175.
van der Aart-van der Beek AB, Clegg LE, Penland RC, Boulton DW, Sjöström CD, Mentz RJ, Holman RR, Heerspink HJL. Effect of once-weekly exenatide on estimated glomerular filtration rate slope depends on baseline renal risk: A post hoc analysis of the EXSCEL trial. Diabetes Obes Metab. 2020 Dec;22(12):2493–2498.
Journal cover image

Published In

Diabetes Obes Metab

DOI

EISSN

1463-1326

Publication Date

December 2020

Volume

22

Issue

12

Start / End Page

2493 / 2498

Location

England

Related Subject Headings

  • Kidney Function Tests
  • Kidney
  • Humans
  • Glomerular Filtration Rate
  • Exenatide
  • Endocrinology & Metabolism
  • Diabetes Mellitus, Type 2
  • 3202 Clinical sciences
  • 1103 Clinical Sciences