Medizinonline Medizinonline
  • News
    • News
    • Market & Medicine
  • Patients
    • Disease patterns
    • Diagnostics
    • Therapy
  • Partner Content
    • Dermatology
      • Atopic dermatitis and psoriasis news
      • Dermatology News
    • Diabetes
      • Dia-Month Club – Type 2 Diabetes
      • Diabetes in Motion
      • Diabetes Podcasts
    • Gastroenterology
      • IBD matters
      • Forum Gastroenterology
      • Ozanimod: ulcerative colitis
      • Reflux Update
    • Immunology
      • Primary immunodeficiency – exchange of experience
    • Vaccinate
      • Herpes zoster
    • Infektiologie
    • Neurology
      • EXPERT ULTRASONIC: Introduction to ultrasound-guided injection
      • MS News
      • MS Therapy in Transition
    • Oncology
      • Swiss Oncology in motion
    • Orthopedics
      • Osteoporosis in motion
    • Phytotherapie
    • Practice Management
      • Aargau Cantonal Bank
      • Claraspital
    • Psychiatry
      • Geriatric Psychiatry
    • Rheumatology
  • Departments
    • Allergology and clinical immunology
    • General Internal Medicine
    • Anesthesiology
    • Angiology
    • Surgery
    • Dermatology and venereology
    • Endocrinology and Diabetology
    • Nutrition
    • Gastroenterology and Hepatology
    • Genetics
    • Geriatrics
    • Gynecology
    • Hematology
    • Infectiology
    • Cardiology
    • Nephrology
    • Neurology
    • Emergency and intensive care medicine
    • Nuclear Medicine
    • Oncology
    • Ophthalmology
    • ORL
    • Orthopedics
    • Pediatrics
    • Pharmacology and toxicology
    • Pharmaceutical medicine
    • Phlebology
    • Physical medicine and rehabilitation
    • Pneumology
    • Prevention and health care
    • Psychiatry and psychotherapy
    • Radiology
    • Forensic Medicine
    • Rheumatology
    • Sports Medicine
    • Traumatology and trauma surgery
    • Tropical and travel medicine
    • Urology
    • Dentistry
  • CME & Congresses
    • CME continuing education
    • Congress Reports
    • Congress calendar
  • Practice
    • Noctimed
    • Practice Management
    • Jobs
    • Interviews
  • Log In
  • Register
  • My account
  • Contact
  • English
    • Deutsch
    • Français
    • Italiano
    • Português
    • Español
  • Publications
  • Contact
  • Deutsch
  • English
  • Français
  • Italiano
  • Português
  • Español
Subscribe
Medizinonline Medizinonline
Medizinonline Medizinonline
  • News
    • News
    • Market & Medicine
  • Patienten
    • Krankheitsbilder
    • Diagnostik
    • Therapie
  • Partner Content
    • Dermatology
      • Atopic dermatitis and psoriasis news
      • Dermatology News
    • Diabetes
      • Dia-Month Club – Type 2 Diabetes
      • Diabetes in Motion
      • Diabetes Podcasts
    • Gastroenterology
      • IBD matters
      • Forum Gastroenterology
      • Ozanimod: ulcerative colitis
      • Reflux Update
    • Immunology
      • Primary immunodeficiency – exchange of experience
    • Vaccinate
      • Herpes zoster
    • Infektiologie
    • Neurology
      • EXPERT ULTRASONIC: Introduction to ultrasound-guided injection
      • MS News
      • MS Therapy in Transition
    • Oncology
      • Swiss Oncology in motion
    • Orthopedics
      • Osteoporosis in motion
    • Phytotherapie
    • Practice Management
      • Aargau Cantonal Bank
      • Claraspital
    • Psychiatry
      • Geriatric Psychiatry
    • Rheumatology
  • Departments
    • Fachbereiche 1-13
      • Allergology and clinical immunology
      • General Internal Medicine
      • Anesthesiology
      • Angiology
      • Surgery
      • Dermatology and venereology
      • Endocrinology and Diabetology
      • Nutrition
      • Gastroenterology and Hepatology
      • Genetics
      • Geriatrics
      • Gynecology
      • Hematology
    • Fachbereiche 14-26
      • Infectiology
      • Cardiology
      • Nephrology
      • Neurology
      • Emergency and intensive care medicine
      • Nuclear Medicine
      • Oncology
      • Ophthalmology
      • ORL
      • Orthopedics
      • Pediatrics
      • Pharmacology and toxicology
      • Pharmaceutical medicine
    • Fachbereiche 26-38
      • Phlebology
      • Physical medicine and rehabilitation
      • Phytotherapy
      • Pneumology
      • Prevention and health care
      • Psychiatry and psychotherapy
      • Radiology
      • Forensic Medicine
      • Rheumatology
      • Sports Medicine
      • Traumatology and trauma surgery
      • Tropical and travel medicine
      • Urology
      • Dentistry
  • CME & Congresses
    • CME continuing education
    • Congress Reports
    • Congress calendar
  • Practice
    • Noctimed
    • Practice Management
    • Jobs
    • Interviews
Login

Sie haben noch keinen Account? Registrieren

  • GLP-1 receptor agonists in type 2 diabetes

Nephroprotection with semaglutide and liraglutide – direct or indirect effects?

    • Congress Reports
    • Endocrinology and Diabetology
    • General Internal Medicine
    • Nephrology
    • Partner Content
    • RX
    • Studies
  • 3 minute read

In a post-hoc analysis of large randomized placebo-controlled trials, HbA1c and body weight and blood pressure were examined as mediator variables regarding the renal protective effects of the GLP-1 receptor agonists semaglutide and liraglutide in type 2 diabetes. The results were presented at this year’s EASD Virtual Meeting.

The composite renal end point of the  cardiovascular end point studies SUSTAIN 6 (n=3297) and LEADER (n=9340) was defined as macroalbuminuria, doubling of serum creatinine, end-stage renal failure, or death of renal cause [1,2]. The GLP-1 receptor agonists(RA) semaglutide and liraglutide showed both cardioprotective and nephroprotective potential in these two studies in patients with type 2 diabetes at high cardiovascular risk. At the EASD Virtual Meeting 2020, Prof. Johannes Mann, MD, Städtisches Klinikum München, Klinik für Nieren-, Hochdruck- und Rheumakrankheiten, spoke about a post-hoc analysis in which the mechanisms of nephroprotective effects were investigated in more detail [3].

Influence of mediator variables quantified

In SUSTAIN 6 and LEADER, the rate of renal events was significantly reduced compared to placebo by 36% (semaglutide) and 22% (liraglutide), respectively. Measurable indirect effects in these two studies were improved glycemic control, blood pressure reduction, and moderate weight loss in the verum condition compared with placebo [3]. (Fig. 1). In the post-hoc analyses of the two CVOTs, Prof. Mann and his team focused on the parameters HbA1c, body weight, and systolic blood pressure as possible mediators of renal protective effects. The analyses showed that in SUSTAIN 6 over a 24-month period, 26% of the differences in the composite renal end point between verum and placebo were mediated by HbA1c. In the LEADER study, this figure was 25% over a 60-month period. These results were similar to those of a corresponding post-hoc analysis of the REWIND study, according to the speaker [3]. In contrast, the mediating effect of blood pressure was 22% in the SUSTAIN 6 study and 9% in the LEADER study [4]. Likewise, 9% were in the LEADER study with regard to body weight. In further analyses with blood pressure as a confounding variable, the value for HbA1c as a mediator variable increased to 36% and for blood pressure and body weight as confounding variables to 30% [4].

 

 

Conclusion

The mediator effects measured in the post-hoc analyses of the SUSTAIN 6 and LEADER trials were largely consistent and indicate that the renal protective effects of semaglutide and liraglutide are not exclusively attributable to HbA1c, blood pressure, and body weight but that there are other relevant, possibly direct, mechanisms. Meanwhile, the FLOW renal endpoint study was launched to investigate whether semaglutide delays the progression of chronic renal failure [6]. Renal outcomes will be examined as the primary endpoint.

Source: EASD 2020

 

Literature:

  1. Marso SP, et al: Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375(19): 1834-1844.
  2. Marso SP, et al: LEADER Trial: liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375: 311-322.
  3. Mann JFE: Renoprotection with Semaglutide and liraglutide – direct or indirect effects? Johannes F.E., M.D. Mann, EASD Virtual Meeting, Sept. 23, 2020
  4. American Society of Nephrology (ASN): abstract SA-OR082, www.asn-online.org/education/kidneyweek/2019/, last accessed 10/19/2020.
  5. Muskiet MHA, et al: GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetesNat Rev Nephrol 2017;13: 605-628.
  6. FLOW: https://clinicaltrials.gov/ct2/show/NCT038 19153

 

HAUSARZT PRAXIS 2020; 15(11): 47
CARDIOVASC 2020; 19(4): 35

Autoren
  • Mirjam Peter, M.Sc.
Publikation
  • HAUSARZT PRAXIS
Related Topics
  • Nephroprotection
  • Renal failure
  • semaglutide
Previous Article
  • Diabetic ketoacidosis

Study: ketoacidosis in infancy affects brain development

  • Endocrinology and Diabetology
  • Neurology
  • Partner Content
  • Pediatrics
  • RX
  • Studies
View Post
Next Article
  • Non-small cell lung cancer

Many lids for many pots

  • Congress Reports
  • Oncology
  • Pneumology
  • RX
View Post
You May Also Like
View Post
  • 5 min
  • Long-term study with dementia patients

Ginkgo biloba extract significantly reduces the risk of progression

    • Education
    • General Internal Medicine
    • Geriatrics
    • Pharmaceutical medicine
    • Phytotherapy
    • Psychiatry and psychotherapy
    • RX
    • Studies
View Post
  • 3 min
  • Intestinal microbiome

Complex and fragile system of microorganisms

    • Education
    • Gastroenterology and Hepatology
    • General Internal Medicine
    • Nutrition
    • RX
View Post
  • 3 min
  • Cancer prevention

Poorer prognosis for men who avoid prostate cancer screening

    • Congress Reports
    • Oncology
    • Prevention and health care
    • RX
    • Studies
    • Urology
View Post
  • 15 min
  • Diabetes mellitus

Treatment of comorbidities in older people

    • Cardiology
    • CME continuing education
    • Endocrinology and Diabetology
    • General Internal Medicine
    • Geriatrics
    • RX
View Post
  • 12 min
  • Liver steatosis with metabolic dysfunction

New nomenclature for non-alcoholic fatty liver disease

    • CME continuing education
    • Gastroenterology and Hepatology
    • General Internal Medicine
    • RX
    • Studies
View Post
  • 4 min
  • Type 2 diabetes: PAD and diabetic foot syndrome

Prevention is better than cure – don’t miss the risk foot

    • Cardiology
    • Congress Reports
    • Endocrinology and Diabetology
    • General Internal Medicine
    • Geriatrics
    • Prevention and health care
    • RX
View Post
  • 2 min
  • Prostate cancer

High-resolution ultrasound could diagnose prostate cancer faster

    • Congress Reports
    • Oncology
    • RX
    • Studies
    • Urology
View Post
  • 9 min
  • Chronic lung diseases

Sarcopenia and malnutrition in the context of pneumological rehabilitation

    • CME continuing education
    • General Internal Medicine
    • Geriatrics
    • Nutrition
    • Pneumology
    • RX
    • Sports Medicine
    • Studies
Top Partner Content
  • Forum Gastroenterology

    Zum Thema
  • Herpes zoster

    Zum Thema
  • Dermatology News

    Zum Thema
Top CME content
  • 1
    Treatment of comorbidities in older people
  • 2
    New nomenclature for non-alcoholic fatty liver disease
  • 3
    Rare malignancy from a dermatological perspective
  • 4
    Communication as the key to therapy adherence
  • 5
    Patience, knowledge and persistence in therapy

Newsletter

Sign up and stay up to date

Subscribe
Medizinonline
  • Contact
  • General terms and conditions
  • Imprint

Input your search keywords and press Enter.