The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system.
Bottom Line: Optimal treatment and prevention of DN may require an early, intensive, multifactorial approach, tailored to simultaneously target all modifiable risk factors.Dipeptidyl peptidase (DPP)-4 inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose levels without additional risk of hypoglycaemia, and may also reduce albuminuria.Further investigation of the potential renal benefits of DPP-4 and SGLT2 inhibitors is underway.
Affiliation: Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria email@example.com.Show MeSH
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Mentions: In addition to GFR, impact on albuminuria has also been investigated in several SGLT2 studies (Table 3). Canagliflozin 100 and 300 mg were associated with greater decreases in UACR compared with placebo, with median percent reductions of −29.9%, −20.9% and −7.5%.86 When these data were analysed with regard to their effects on albuminuria progression (normo- to micro-/macroalbuminuria or micro- to macroalbuminuria), the proportion of patients that progressed were 5.1%, 8.3% and 11.8% in the canagliflozin 100 mg, 300 mg and placebo groups, respectively, with odds ratios (95% confidence interval (CI)) of 0.33 (0.08, 1.48) and 0.51 (0.14, 1.91) for the pairwise comparisons of canagliflozin 100 and 300 mg to placebo, respectively.86 Additional studies analysing UACR changes and progression as part of a cardiovascular safety report for the Food and Drug Administration, showed similar changes (Figure 5) in a larger group of more than 3000 individuals.92
Affiliation: Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria firstname.lastname@example.org.