In the REWIND (Researching cardiovascular Events with a Weekly INcretin in Diabetes) trial, the use of dulaglutide (DU) was associated with a 25% reduced hazard of a kidney function–related outcome, researchers report. These findings highlight the potential for DU in delaying or slowing the development of diabetic kidney disease in people with type 2 diabetes, the authors conclude.
Among 4,949 participants on DU and 4,952 participants on placebo, the authors looked at the time to occurrence of a composite kidney function–related outcome (≥40% sustained decline in estimated glomerular filtration rate (eGFR), end-stage renal disease, or renal-related death). Mean annual eGFR slope was also determined.
Among all participants and in subgroups based on baseline urinary albumin-to-creatinine ratio (UACR <30 or ≥30 mg/g) and baseline eGFR (<60 or ≥60 mL/min/1.73 m2), the investigators found: “The post hoc composite kidney function–related outcome occurred less frequently among participants assigned to DU than placebo (hazard ratio [HR] 0.75, 95% CI 0.62–0.92, P = 0.004), with no evidence of a differential DU treatment effect by UACR or eGFR subgroup. A ≥40% sustained eGFR decline occurred less frequently among participants assigned to DU than placebo (HR 0.72, 95% CI 0.58–0.88, P = 0.002). The mean annual decline in eGFR slope was significantly smaller for participants assigned to DU than placebo (−1.37 vs. −1.56 mL/min/1.73 m2/year, P < 0.001); results were similar for all subgroups.”