An analysis presented at the American Diabetes Association’s 79th Scientific Sessions shows that patients with type 2 diabetes and moderate-to-severe chronic kidney disease who took 1.5 mg of dulaglutide once a week saw reduced clinical events associated with end-stage kidney disease, when compared with those using insulin or a lower dose of dulaglutide.
AWARD-7, the international trial conducted at 99 sites in nine countries from 2012 to 2015, comprised of 577 adults with type 2 diabetes and moderate to severe CKD (stages 3-4) with hemoglobin A1C from 7.5% to 10.5% were randomly assigned to receive either 1.5 mg of dulaglutide, 0.75 mg of dulaglutide, or insulin glargine.
The study showed that after one year, participants in the 1.5 mg group saw increased kidney function and equivalent control of blood glucose levels between the dulaglutide and insulin treatment groups.
“Specifically, use of 1.5 mg weekly of dulaglutide was associated with a lower rate of CKD outcomes, including eGFR decline ≥40% or reduction of end-stage renal disease, compared to treatment with insulin,” explained the press release regarding the presentation. “Blood pressure control and the use of antihypertensive medicines, such as renin-angiotensin system inhibitors that protect the kidney, were also similar between groups. Rates of hypoglycemia reactions were significantly lower with dulaglutide versus insulin treatment. Additionally, treatment with dulaglutide resulted in weight loss, while insulin produced weight gain.”
“These results from AWARD-7 were particularly striking because of the marked reduction in clinical events with dulaglutide treatment among participants with moderate to severe chronic kidney disease who are already receiving the current standard-of-care (renin-angiotensin system inhibitors),” said lead investigator Katherine R Tuttle, MD, FASN, FACP, FNKF, executive director for research at Providence Health Care, co-principal investigator of the Institute of Translational Health Sciences, and professor of medicine at the Kidney Research Institute and the University of Washington, in a press release regarding the study. “Until now, very few treatments have been shown to reduce the risk of end-stage-kidney disease and show an up to 40% eGFR decline at more advanced stages of chronic kidney disease. It is encouraging to see that newer glucose-lowering treatments, such as dulaglutide, protect the kidneys and may prevent serious complications even in individuals who are at stage 3 or 4 chronic kidney disease.” —Edan Stanley