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The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system.

Schernthaner G, Mogensen CE, Schernthaner GH - Diab Vasc Dis Res (2014)

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.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria guntram.schernthaner@meduniwien.ac.at.

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Related in: MedlinePlus

Proportion of participants in canagliflozin cardiovascular safety study in patients with T2DM experiencing a ≥1-step progression in albuminuria stage.Source: Coelln-Hough et al.92T2DM: type 2 diabetes mellitus.
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fig5-1479164114542802: Proportion of participants in canagliflozin cardiovascular safety study in patients with T2DM experiencing a ≥1-step progression in albuminuria stage.Source: Coelln-Hough et al.92T2DM: type 2 diabetes mellitus.

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


The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system.

Schernthaner G, Mogensen CE, Schernthaner GH - Diab Vasc Dis Res (2014)

Proportion of participants in canagliflozin cardiovascular safety study in patients with T2DM experiencing a ≥1-step progression in albuminuria stage.Source: Coelln-Hough et al.92T2DM: type 2 diabetes mellitus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4230539&req=5

fig5-1479164114542802: Proportion of participants in canagliflozin cardiovascular safety study in patients with T2DM experiencing a ≥1-step progression in albuminuria stage.Source: Coelln-Hough et al.92T2DM: type 2 diabetes mellitus.
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

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.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria guntram.schernthaner@meduniwien.ac.at.

Show MeSH
Related in: MedlinePlus