According to the findings of the AWARD-7 study, which were presented at the American Diabetes Association’s (ADA’s) 79th Scientific Sessions in San Francisco, dulaglutide is a safe medication for type 2 diabetes (T2D) patients with moderate-to-severe chronic kidney disease (CKD).
AWARD-7 took place at 99 sites in nine countries between 2012 and 2015. Patients with T2D and moderate-to-severe CKD (stages 3—4) with A1C from 7.5—10.5% were randomized to one of three treatment groups: 1.5 mg of dulaglutide (n = 193), 0.75 mg of dulaglutide (n = 190), and insulin glargine (n = 194).
Dulaglutide treatment, compared to insulin, was associated with a slower estimated glomerular filtration rate (eGFR) decline. At one year, the 1.5 mg dulaglutide group had a lower rate of CKD outcomes—including eGFR decline ≥ 40% or end-stage renal disease (ESRD)—compared to the insulin group (5.2% vs. 10.8%); in the lower-dose dulaglutide group, the rate was 8.4%. The 1.5 dulaglutide group had a 4
The results differed when patients were stratified by albuminuria status. For patients with microalbuminuria (UACR < 30-300 mg/g), the rates of 40% eGFR decline or ESRD events were: 1.5 mg dulaglutide, 2.7%; 0.75 dulaglutide, 3.3%; and insulin, 1.8%. Among patients with macroalbuminuria (UACR > 300 mg/g), the rates were 7.1%, 16.7%, and 22.2%, respectively.
“Until now, very few treatments have been shown to reduce the risk of end-stage-kidney disease and show an up to 40% eGFR decline at more advanced stages of chronic kidney disease, said lead investigator Katherine R. Tuttle, MD, FASN, FACP, FNKF, executive director for research at Providence Health Care, co-principal investigator of the Institute of Translational Health Sciences, and professor of medicine at the Kidney Research Institute and the University of Washington, in a press release. “It is encouraging to see that newer glucose-lowering treatments, such as dulaglutide, protect the kidneys and may prevent serious complications even in individuals who are at stage 3 or 4 chronic kidney disease.”