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Kidney Week

Abstract: PO1017

Dulaglutide and Kidney Function-Related Outcomes in Type 2 Diabetes: Post Hoc Analysis from the REWIND Trial

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Shaw, Jonathan E., Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
  • Botros, Fady T., Eli Lilly and Company, Indianapolis, Indiana, United States
  • Malik, Raleigh, Eli Lilly and Company, Indianapolis, Indiana, United States
  • Atisso, Charles M., Eli Lilly and Company, Indianapolis, Indiana, United States
  • Gerstein, Hertzel C., Population Health Research Institute, Hamilton, Ontario, Canada
Background

Over the median follow-up of 5.4 years in the REWIND trial, which included participants with type 2 diabetes (T2D) and multiple cardiovascular (CV) risk factors, dulaglutide (DU) use was associated with a reduction in composite renal outcomes, defined as the first occurrence of new macroalbuminuria, sustained decline in estimated glomerular filtration rate (eGFR) of ≥30% (using the modification of diet in renal disease [MDRD] equation), or chronic renal replacement therapy. This posthoc analysis evaluated the potential effects of dulaglutide on renal outcomes using an alternative endpoint definition that is commonly used in renal outcomes studies; defined as the composite endpoint of sustained eGFR decline ≥40% (using the chronic kidney disease-epidemiology collaboration [CKD-EPI] equation), end-stage renal disease (ESRD), or all-cause death.

Methods

REWIND participants were randomized (1:1) to DU 1.5 mg once weekly or placebo. Cox proportional hazards model for time-to-first event analysis was used to determine the risk of renal outcomes. Subgroup analyses were conducted by baseline eGFR and albuminuria status.

Results

At baseline, treatment groups had similar eGFR values (mean±SD: DU=77.6 ± 19.4 mL/min/1.73 m2; placebo=77.1 ± 19.6 mL/min/1.73 m2). The incidence rate of the composite endpoint was significantly lower for the DU group compared with placebo. This effect was consistent regardless of baseline eGFR or albuminuria status (Table).

Conclusion

Treatment with DU 1.5 mg was associated with a 17% risk reduction in the composite renal outcome, suggesting potential delay in progression of diabetic kidney disease in patients with T2D at CV risk.

Funding

  • Commercial Support