In:
American Journal of Nephrology, S. Karger AG, Vol. 54, No. 1-2 ( 2023), p. 74-82
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 In the AWARD-7 study in patients with type 2 diabetes and moderate-to-severe chronic kidney disease, once-weekly dulaglutide slowed the decline in estimated glomerular filtration rate (eGFR) and decreased the urine albumin/creatinine ratio compared to insulin glargine at the end of 52 weeks of treatment. In this exploratory post hoc analysis, changes in two fibrosis biomarkers, serum PRO-C6 (type VI collagen formation) and urine C3M (type III collagen degradation), were evaluated. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In the groups treated with dulaglutide 1.5 mg or insulin glargine ( 〈 i 〉 N 〈 /i 〉 = 330), serum PRO-C6 and urine C3M were measured using competitive enzyme-linked immunosorbent assays. Biomarker changes were assessed by a mixed-effects model for repeated measures. Pearson correlation analyses were conducted to determine associations between changes in kidney fibrosis biomarkers and eGFR measures at 52 weeks. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 At weeks 26 and 52 of treatment in the overall population, serum PRO-C6 levels were significantly lower in the dulaglutide group versus insulin glargine group with percent change from baseline of (least squares mean ± standard error) −4.6% ± 1.9 and −0.2% ± 2.2 versus 5.7% ± 2.0 and 8.0% ± 2.3 ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.01), respectively, and urine C3M levels were significantly higher in the dulaglutide group versus insulin glargine group with percent change from baseline of 10.9% ± 8.2 and 20.7% ± 8.8 versus −10.0% ± 6.5 and −16.9% ± 6.4 ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05), respectively. These findings appeared greater in the subgroup with macroalbuminuria. Serum PRO-C6 negatively correlated with eGFR, while urine C3M positively correlated with eGFR. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Dulaglutide treatment was associated with biomarker changes that indicated lower type VI collagen formation and higher type III collagen degradation compared to treatment with insulin glargine, suggesting a potential drug effect to reduce kidney fibrosis.
Type of Medium:
Online Resource
ISSN:
0250-8095
,
1421-9670
Language:
English
Publisher:
S. Karger AG
Publication Date:
2023
detail.hit.zdb_id:
1468523-1
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