Semaglutide in diabetic kidney disease: Experience in two kidney health programs in Colombia
PDF (Español (España))
xhtml (Español (España))

Keywords

Type 2 Diabetes Mellitus
Kidney Chronic Disease
albuminuria
Glucagon-Like Peptide 1 (MeSH)

How to Cite

Daza-Arnedo, R. ., Rico-Fontalvo, J., Raad-Sarabia, M., Ramos-Clason, E., Bohórquez-Rivero, J. ., Montejo-Hernández, J., Cabrales-Juan, J., Escobar-Pacheco, C., Acosta-Pérez, T., Henao-Ramirez, C., Cardona-Blanco, M., & Martinez-Avila, M. (2022). Semaglutide in diabetic kidney disease: Experience in two kidney health programs in Colombia. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 9(3). https://doi.org/10.53853/encr.9.3.776

Abstract

Background: Semaglutide has shown renal benefits in previous studies; however, its efficacy and safety in patients with diabetic kidney disease in the Latin American population have been poorly studied.

Purpose: To detail the clinical results and to evaluate the glycemic and renal efficacy and safety of semaglutide in patients with DKD during 6 months of follow-up.

Materials and methods: Retrospective observational study that included patients with type 2 diabetes mellitus (DM2) and renal compromise, with glycated hemoglobin (HbA1c) between 7.5-10%, treated with subcutaneous semaglutide for 6 months.

Results: 30 patients, age (63-75 years), 60% Women. Duration of DM2: 10 years and median baseline HbA1c 8.3% (7.5-10%), occasional urine albuminuria/creatinuria ratio (RAC) 76.6 mg/g (8.8-670 mg/g), creatinine 1, 5 mg/dl (0.85 - 1.87 mg/dl), estimated glomerular filtration rate (eGFR) 43.5 ml/min (28.0 -94.0 ml/min). Statistical significance was found in the decrease in HbA1c with a median at 3 months of 7.2% (IQR: 6.5 - 7.9) and at 6 months of 6.8% (IQR: 6.3 - 7.4), p=0.0040. In the subgroup analysis, in patients with albuminuria A3=816 mg/g (612 - 1670), a statistically significant decrease was observed with a median of 754 mg/g at 3 months (IQR: 514 - 1450) and at 6 months of 310mg/g (IQR: 258-340), p=0.0060. We did not obtain statistically significant results in terms of improvement in blood pressure (BP), weight, and lipid control.

Conclusion: In real-life clinical practice, semaglutide proved to be an effective and safe drug for adequate glycemic control in patients with diabetic kidney disease, also demonstrating a reduction in albuminuria in patients with category A3.

https://doi.org/10.53853/encr.9.3.776
PDF (Español (España))
xhtml (Español (España))

References

Rico-Fontalvo JE, Daza-Arnedo R, Raad M, Pájaro N, Correa-Guerrero J, Villacob-Oviedo A, et al. Agonistas del receptor Glp-1: Desde su efecto fisiológico en el sistema incretina hasta du rol en enfermedad renal diabética. Arch Med. 2021;17(2).

Natali A, Nesti L, Tricò D, Ferrannini E. Effects of GLP-1 receptor agonists and SGLT-2 inhibitors on cardiac structure and function: a narrative review of clinical evidence. Cardiovasc Diabetol. 2021;20. https://doi.org/10.1186/s12933-021-01385-5

Martinez-Castelao A, Soler MJ, Navarro-González JF, Górriz JL. ¿Serán las nuevas moléculas efectivas en protección renal y cardiovascular en la diabetes mellitus y la enfermedad renal diabética? Nefrología. 2019;39(1):3-10. https://doi.org/10.1016/j.nefro.2018.05.011

Oellgaard J, Gæde P, Rossing P, Persson F, Parving HH, Pedersen O. Intensified multifactorial intervention in type 2 diabetics with microalbuminuria leads to long-term renal benefits. Kidney Int. 2017;91(4). https://doi.org/10.1016/j.kint.2016.11.023

Magee C, Grieve DJ, Watson CJ, Brazil DP. Diabetic Nephropathy: a Tangled Web to Unweave. Cardiovasc Drugs Ther. 2017;31:579-92. https://doi.org/10.1007/s10557-017-6755-9

Zoungas S, Arima H, Gerstein HC, Holman RR, Woodward M, Reaven P, et al. Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials. Lancet Diabetes Endocrinol. 2017;5(5). https://doi.org/10.1016/S2213-8587(17)30104-3

Rangaswami J, Bhalla V, De Boer IH, Staruschenko A, Sharp JA, Singh RR, et al. Cardiorenal protection with the newer antidiabetic agents in patients with diabetes and chronic kidney disease: A scientific statement from the American Heart Association. Circulation. 2020.

Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375:1834-44. https://doi.org/10.1056/NEJMoa1607141

Mann J, Ørsted D, Brown-Frandsen K, Marso S, Poulter N, Rasmussen S, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med. 2017;377:829-48. https://doi.org/10.1056/NEJMoa1616011

Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394:121-30. https://doi.org/10.1016/s0140-6736(19)31149-3

Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Køber LV, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med. 2015;373:2247-57. https://doi.org/10.1056/NEJMoa1509225

Górriz JL, Soler MJ, Navarro-González JF, García-Carro C, Puchades MJ, D’marco L, et al. GLP-1 receptor agonists and diabetic kidney disease: A call of attention to nephrologists. J Clin Med. 2020;9(4):947. https://doi.org/10.3390/jcm9040947

Rojano-Toimil A, Ciudin A. GLP-1 receptor agonists in diabetic kidney disease: From physiology to clinical outcomes. J Clin Med. 2021;10(17):3955. https://doi.org/10.3390/jcm10173955

Gerstein HC, Sattar N, Rosenstock J, Ramasundarahettige C, Pratley R, Lopes RD, et al. Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes. N Engl J Med. 2021;385:896-907. https://doi.org/10.1056/NEJMoa2108269

Yin WL, Bain SC, Min T. The Effect of Glucagon-Like Peptide-1 Receptor Agonists on Renal Outcomes in Type 2 Diabetes. Diabetes Ther. 2020;11:835-44. https://doi.org/10.1007/s13300-020-00798-x

Aviles-Bueno B, Soler MJ, Perez-Belmonte L, Jimenez-Millan A, Rivas-Ruiz F, Garcia-de Lucas MD. Semaglutide in type 2 diabetes with chronic kidney disease at high risk progression-real-world clinical practice. Clin Kidney J. 2022;15(8):1593-600. https://doi.org/10.1093/ckj/sfac096

Mosenzon O, Blicher TM, Rosenlund S, Eriksson JW, Heller S, Hels OH, et al. Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2019;68(supl. 1):1004. https://doi.org/10.2337/db19-1004-P

Latini R, Staszewsky L. Semaglutide and effective weight control. Lancet. 2021;397(10278):942-3. https://doi.org/10.1016/S0140-6736(21)00377-9

Wilding JP, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384:989-1002. https://doi.org/10.1056/NEJMoa2032183

Duran-Salgado MB, Rubio-Guerra AF. Diabetic nephropathy and inflammation. World J Diabetes. 2014;5(3):393-8. https://doi.org/10.4239/wjd.v5.i3.393

Ahmann AJ, Capehorn M, Charpentier G, Dotta F, Henkel E, Lingvay I, et al. Efficacy and safety of once-Weekly semaglutide versus exenatide ER in subjects with type 2 diabetes (SUSTAIN 3): A 56-Week, open-Label, randomized clinical trial. Diabetes Care. 2018;41(2):258-66. https://doi.org/10.2337/dc17-0417

Rodbard HW, Lingvay I, Reed J, De La Rosa R, Rose L, Sugimoto D, et al. Semaglutide Added to Basal Insulin in Type 2 Diabetes (SUSTAIN 5): A Randomized, Controlled Trial. J Clin Endocrinol Metab. 2018;103(6):2291-301. https://doi.org/10.1210/jc.2018-00070

Zinman B, Bhosekar V, Busch R, Holst I, Ludvik B, Thielke D, et al. Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2019;7(5):356-367. https://doi.org/10.1016/S2213-8587(19)30066-X

Kawanami D, Takashi Y. GLP-1 Receptor Agonists in Diabetic Kidney Disease: From Clinical Outcomes to Mechanisms. Front. Pharmacol. 2020. https://doi.org/10.3389/fphar.2020.00967

Sposito AC, Berwanger O, De Carvalho LS, Saraiva JF. GLP-1RAs in type 2 diabetes: Mechanisms that underlie cardiovascular effects and overview of cardiovascular outcome data. Cardiovasc Diabetol. 2018;17. https://doi.org/10.1186/s12933-018-0800-2

Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol. 2021. https://doi.org/10.3389/fendo.2021.645563

Smits MM, Van Raalte DH. Corrigendum: Safety of Semaglutide. Front Endocrinol (Lausanne). 2021;12. https://doi.org/10.3389/fendo.2021.786732

Rico-Fontalvo JE. Guía de práctica clínica para la enfermedad renal diabética. Rev Colomb Nefrol. 2021;8(2). https://doi.org/10.22265/acnef.8.2.561

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2022 Revista Colombiana de Endocrinología, Diabetes & Metabolismo

Dimensions


PlumX


Downloads

Download data is not yet available.