Effects of Liraglutide Versus Placebo on Cardiovascular Events in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease

Abstract

Supplemental Digital Content is available in the text.

Emerging urine-based proteomic biomarkers as valuable tools in the management of chronic kidney disease

“…Glucagon-like peptide-1 (GLP-1) receptor agonists bind to the GLP-1 receptor, promote insulin secretion and inhibit glucagon secretion. A study also showed that the risk of ESRD is reduced by 22% [16] upon treatment with a GLP-1 agonist. At the molecular level, GLP-1 agonists show anti-oxidative, anti-inflammatory, and anti-fibrotic effects, thought to be responsible for the positive effect of the substance class in the treatment of DKD [17].…”

Pharmacologic strategies to reduce cardiovascular disease in type 2 diabetes mellitus: focus on SGLT‐2 inhibitors and GLP‐1 receptor agonists

“…Recently, a post hoc analysis of the LEADER trial focusing on elderly patients at high CV risk (75 years or older) showed a reduction for MACEs (HR 0.66, 95% CI 0.49–0.89, P = 0.006) and expanded MACE outcomes (including MACE or coronary revascularization, hospitalization for unstable angina or HF, each component of the composite CV outcomes, and all‐cause and non‐CV death, HR 0.71, 95% CI 0.55–0.91, P = 0.007) compared to placebo . A subanalysis of the LEADER trial also found that liraglutide reduced the risk of MACE in subgroups of patients with T2D, high CV risk, and chronic kidney disease, including those with low estimated glomerular filtration rate and/or elevated albuminuria, as effectively as patients without renal impairment . Although the LEADER study found a nonsignificant 13% relative risk reduction in hospitalization for HF, the Functional Impact of GLP‐1 for Heart Failure Treatment (FIGHT) study showed a negative impact of liraglutide in patients with advanced HF with reduced ejection fraction (HFrEF), especially in those with T2D .…”

Key updates in Cardio-Nephrology from 2018: Springboard to a Bright Future

“…This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; HR: 0.74; 95% CI, 0.60 to 0.91) (Mann et al, 2017). A recent post-hoc analysis of the Liraglutide Effect and Action in Diabetes (LEADER) trial reported that in patients with eGFR <60 mL/min/1.73 m 2 , risk reduction for the primary composite cardiovascular outcome with liraglutide was greater (HR: 0.69; 95% CI, 0.57-0.85) versus those with eGFR ≥ 60 mL/min/1.73 m 2 (HR, 0.94; 95% CI, 0.83-1.07) (Mann et al, 2018). These results appear to apply across the CKD spectrum enrolled, which is another encouraging development in cardio-renal risk reduction in diabetic kidney disease for the future.…”