Lixisenatide Cuts Kidney Damage in T2DM and Coronary Syndrome

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Lixisenatide reduces progression of urinary albumin-creatinine ratio in patients with macroalbuminuria.
Lixisenatide reduces progression of urinary albumin-creatinine ratio in patients with macroalbuminuria.

(HealthDay News) -- For patients with type 2 diabetes and acute coronary syndrome, lixisenatide can slow or prevent damage to the kidneys, according to a study published online in The Lancet Diabetes & Endocrinology. The research was published to coincide with the annual meeting of the European Association for the Study of Diabetes, held from Oct 1 to 5 in Berlin.

Marcel H.A. Muskiet, MD, from the VU University Medical Center in Amsterdam, and colleagues conducted a randomized trial at 828 sites in 49 countries. Patients with type 2 diabetes and a recent coronary artery event were randomized to a daily subcutaneous injection of lixisenatide or volume-matched placebo in addition to usual care. The percentage change in urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate were assessed according to prespecified albuminuria status at baseline. Baseline UACR data were available for 5978 patients.

Overall, 74, 19, and 7% of participants had normoalbuminuria, microalbuminuria, and macroalbuminuria at baseline. The researchers found that the placebo-adjusted least-squares mean percentage change in UACR from baseline with lixisenatide was −1.69% (P=0.7398), −21.20% (P=0.0502), and −39.18% (P=0.0070) for patients with normoalbuminuria, microalbuminuria, and macroalbuminuria, respectively, after 108 weeks of follow-up. When adjusted for baseline hemoglobin A1c (HbA1c) or baseline and on-trial HbA1c, lixisenatide was associated with reduced risk for new-onset macroalbuminuria.

"Lixisenatide reduces progression of UACR in macroalbuminuric patients, and is associated with a lower risk of new-onset macroalbuminuria after adjustment for baseline and on-trial HbA1c and other traditional renal risk factors," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Sanofi, which manufactures lixisenatide and funded the study.

References

Muskiet MHA, Tonneijck L, Huang Y, et al. Lixisenatide and renal outcomes in patients with type 2 diabetes and acute coronary syndrome: an exploratory analysis of the ELIXA randomised, placebo-controlled trial. Lancet: Diab & Endo. DOI: 10.1016/S2213-8587(18)30268-7

Wong MG, Jardine M, Perkovic V. Glucose lowering and the kidney: are all drug classes equal? Lancet: Diab & Endo. DOI:10.1016/S2213-8587(18)30291-2

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