Kidney Week

Abstract: FR-OR088

Dulaglutide Treatment Is Associated with Less eGFR Decline and Greater Reduction in Albuminuria in Type 2 Diabetes and CKD Stages 3-4 (AWARD-7)

Session Information

• SGLT-2 Inhibitors and Diabetic Kidney Disease
  November 03, 2017 | Location: Room 282, Morial Convention Center
  Abstract Time: 04:30 PM - 04:42 PM

Category: Diabetes

• 502 Diabetes Mellitus and Obesity: Clinical

Authors

• Tuttle, Katherine R., Providence Health Care, University of Washington School of Medicine, Spokane, Washington, United States

Katherine R. Tuttle, MD, FASN



Katherine R. Tuttle, MD, FASN, FACP, FNKF is the Executive Director for Research at Providence Health Care in Spokane, Washington. Dr. Tuttle serves the University of Washington as a Co-Principal Investigator of the Institute of Translational Health Sciences, established Investigator at the Kidney Research Institute, and Clinical Professor of Medicine. She is a member of the Board of Directors for the Kidney Health Initiative. She was Associate Editor for the Clinical Journal of the American Society of Nephrology from 2011-2016. She chaired the Healthcare Professional Workgroup for the National Diabetes Education Program (2006-2011), the National Kidney Foundation - Kidney Disease Outcomes Quality Initiative Workgroup for Diabetes and Chronic Kidney Disease (2004-2012), the Institutional Review Board – Spokane (1999-2012), the Diabetes and Chronic Kidney Disease Consensus Conference for the American Diabetes Association (2014), and the National Kidney Foundation Young Investigator Awards (2014). She has received the Garabed Eknoyan Award from the National Kidney Foundation (2017), the YWCA Woman of Achievement Award in Science (2009), and two Outstanding Clinical Faculty Awards at the University of Washington (1992, 2012). Dr. Tuttle holds fellowships in the American College of Physicians, the American Society of Nephrology, and the National Kidney Foundation. Her major professional interests are diabetic kidney disease, hypertension, and chronic kidney disease.

• Lakshmanan, Mark C., Eli Lilly and Company, Indianapolis, Indiana, United States

Mark C. Lakshmanan,

• Gross, Jorge L., Centro de Pesquisas em Diabetes, Porto Alegre, Rio Grande do Sul, Brazil

Jorge L. Gross,

• Rayner, Brian, Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa

Brian Rayner,

• Busch, Robert S., Albany Medical Center Division of Community Endocrinology, Albany, New York, United States

Robert S. Busch,

• Woodward, Brad, Eli Lilly and Company, Indianapolis, Indiana, United States

Brad Woodward,

• Zimmermann, Alan G., Eli Lilly and Company, Indianapolis, Indiana, United States

Alan G. Zimmermann,

• Botros, Fady T., Eli Lilly and Company, Indianapolis, Indiana, United States

Fady T. Botros,

Background

The AWARD-7 phase 3 trial compared weekly dulaglutide (DU 1.5 or 0.75 mg) to daily insulin glargine (IG), both with insulin lispro, in participants with type 2 diabetes (T2D) and chronic kidney disease (CKD) stages 3-4.

Methods

Baseline (BL) characteristics (N=576) were: estimated glomerular filtration rate (eGFR CKD-EPI): 38±13 mL/min/1.73m² [mean±SD], urine albumin/creatinine ratio (UACR, mean [median]): 847.2 (209.3), age: 65±9 years, A1c: 8.6±1.0%, duration of T2D: 18±9 years.

Results

After 52 weeks, mean eGFR was not statistically different from BL with DU 1.5 mg, while it decreased with DU 0.75 mg and IG; UACR decreased from BL with both DU doses (table). DU 1.5 mg vs IG differences were statistically significant in participants with UACR >300 mg/g. Both doses of DU were noninferior to IG for the change in A1c.

Conclusion

In participants with T2D and CKD stages 3-4, overall effects on eGFR and UACR were mainly driven by lesser eGFR decline and greater UACR reduction in the DU 1.5 mg group vs IG in participants with UACR >300 mg/g.

Table. Effects of DU and IG on eGFR and albuminuria after 52 weeks

Data are change from BL least squares mean (95% confidence interval). *2-sided p<0.05 and **2-sided p<0.001 change from BL, ^#2-sided p<0.05 and ^##2-sided p<0.001 vs IG

Funding

• Commercial Support – Eli Lilly and Company