Abstract: PUB145
Effect of Tirzepatide on Intermediate Outcomes in ANCA-Associated Vasculitis
Session Information
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Yang, Anita, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Falk, Ronald, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Zeitler, Evan, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Background
The role of incretin mimetics in autoimmune kidney disease is unclear. Anti-neutrophil cytoplasmic antibody (ANCA)–associated vasculitis is complicated by proteinuria and progressive kidney dysfunction. Management relies on immunosuppression associated with significant toxicity and metabolic complications. Given the anti-inflammatory and renoprotective effects of incretins, these agents may offer adjunctive benefit. We aimed to evaluate the impact of tirzepatide on proteinuria and weight in patients with ANCA vasculitis.
Methods
Single-center, retrospective chart review of adult patients with ANCA vasculitis who received an incretin receptor agonist for > 3 months from 1/1/2022-12/31/2025. Patients were excluded if they were pregnant or had a previous history of transplantation. Patients were followed until discontinuation of therapy or end of the study period. The primary outcome was the change in urine protein-creatinine ratio (UPCR) from baseline (prior to tirzepatide therapy). Secondary outcomes included changes in weight, body mass index (BMI), eGFR, and hematuria profile.
Results
Of 23 patients identified, 9 met inclusion criteria; 11 were excluded due to medication access barriers and 3 did not have follow up UPCR. This cohort was predominantly older, White females with obesity and a low prevalence of diabetes (Table 1). Following median tirzepatide therapy of 11.7 months (IQR 7.3-16.1), UPCR decreased irrespective of degree of weight loss, eGFR remained stable, and hematuria was stable or decreased (Figure 1).
Conclusion
In this small cohort of patients with ANCA vasculitis, tirzepatide was associated with UPCR reductions independent of weight loss, suggesting a renoprotective effect beyond metabolic benefits. Further mechanistic and interventional studies are needed.
Pre- and post-treatment characteristics of the cohort. In D), red dots = baseline UPC of >0.3 g/g.