Lixisenatide prevents damage to kidneys in diabetes and CVD patients

Research presented at the annual meeting of the European Association for the Study of Diabetes (EASD) shows how the glucose-lowering drug can slow or prevent damage to the kidneys in in macro-albuminuric patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD).

Dr Marcel Muskiet at Amsterdam University Medical Centre presented the study along with his colleagues.

The short acting glucagon-like peptide 1 receptor agonist (GLP-1RA), lixisenatide, showed CVD safety in comparison to a placebo in T2DM patients. In the follow up study, the researchers investigated the effect of lixisenatide on renal outcomes where T2DM patients with a recent coronary artery event were assigned to lixisenatide (10-20 μg) or placebo, as well as standard of care. 

During the study, 6,068 patients were enrolled, with 99 percent of the patients having a median follow-up time of 25 months. At baseline, 74 percent had normoalbuminuria, 19 percent had microalbuminuria, and 7 percent had macroalbuminuria. 

The team investigated the progression of UACR, and the glomerular filtration rate (eGFR), a measure of kidney function, according to specific pre-specified baseline UACR categories. The time to new onset of macroalbuminuria and the doubling of serum creatinine were also determined by the researchers.

The scientists found that lixisenatide was associated with borderline statistically significant reduction of 16 percent in the risk of any incidence of macroalbuminuria.

The authors said: “On the basis of available evidence, GLP-1RAs reduce UACR across the range of eGFR (CKD stages 1-4), particularly in patients with macroalbuminuria at baseline. It can be speculated that direct GLP-1 receptor activation in the kidney, or multiple anti-inflammatory and anti-oxidative stress effects, may contribute to the suggested renal benefits of GLP-1RAs. The effect of GLP-1RAs on eGFR decline and hard renal endpoints remains equivocal, and should be investigated in dedicated renal outcome studies with longer follow-up time in T2DM patients with more advanced CKD at baseline.”

The research was published in The Lancet Diabetes & Endocrinology.