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    Home > Active Ingredient News > Endocrine System > Meta analysis of the kidney protection of new hypoglycemic drugs, SGLT-2 inhibitors are worthy of attention

    Meta analysis of the kidney protection of new hypoglycemic drugs, SGLT-2 inhibitors are worthy of attention

    • Last Update: 2021-04-19
    • Source: Internet
    • Author: User
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    Diabetes is one of the main causes of chronic kidney disease (CKD), and some type 2 diabetes has kidney damage when it is diagnosed.

    The prevalence of CKD in diabetic patients in my country exceeds 20%, which is significantly higher than that of the general population.

    At present, three new hypoglycemic drugs have been put into clinical practice, namely sodium-glucose cotransporter 2 inhibitor (SGLT-2i), glucagon-like peptide-1 receptor agonist (GLP-1RA) and dipeptidyl Peptidase 4 inhibitor (DPP-4i).

    How do they perform in the clinic? Recently, a scholar published an article in J Clin Endocrinol Metab, and conducted a systematic review and meta-analysis of the kidney-protecting effects of three new hypoglycemic drugs based on existing clinical data.

    Study design Researchers collected clinical information on kidney safety priorities and new-type hypoglycemic drugs on MEDLINE.
    The publication time of the included study is from January 2013 to March 2020.

    The trial must be a clinical trial for adults, related to three new hypoglycemic drugs, and a compound renal outcome was observed.

    The composite renal outcome here includes renal death, end-stage renal disease (ESKD, including: kidney transplantation and initiation of maintenance hemodialysis), new massive proteinuria, and estimated glomerular filtration rate (eGFR) <15ml for at least 30 days /min/1.
    73㎡.

    This meta-analysis included 7 related trials and 6 drugs (see Table 1), conducted within the Bayesian framework, using fixed-effects models and uninformed priors.

    The study results analyzed the clinical trial data and obtained the following results: Compared with placebo, the risk ratio (HR) of the compound renal outcome in the canagliflozin group was 0.
    63 (95% CI, 0.
    54-0.
    74), dapagliflozin Net is 0.
    53 (95% CI, 0.
    43-0.
    66), Empagliflozin is 0.
    54 (95% CI, 0.
    39-0.
    74), Liraglutide is 0.
    78 (95% CI, 0.
    67-0.
    91), Smeglutide It is 0.
    64 (95% CI, 0.
    46-0.
    89).

    In short, the above drugs can significantly reduce the risk of compound renal outcome, but the HR is different.

    Compared with placebo, linagliptin showed a neutral result for the composite renal outcome (HR=1.
    04, 95% CI, 0.
    89-1.
    22).

     The limitations of this analysis are that the baseline characteristics of participants in each trial are slightly different, the number of trials included is small, some new hypoglycemic drugs are not included in the discussion, and the representative drugs are different.

    Therefore, further research is needed in the future.

    The six drugs included in the analysis of this study represent SGLT-2 inhibitors, GLP-1 receptor agonists and DPP-4 inhibitors.

    Current data support that SGLT-2 inhibitors and GLP-1 receptor agonists can effectively protect the renal function of diabetic patients, and DPP-4 inhibitors have a neutral result.

    References: 1.
    Li Sheran, Niu Jianying, Gu Yong.
    Epidemiological research on diabetic kidney disease[J].
    Journal of Clinical Nephrology, 2014, 000(010):635-638.
    2.
    Cha AS, Chen Y, Fazioli K, at el.
    Microvascular Benefits of New Antidiabetic Agents: A Systematic Review and Network Meta-Analysis of Kidney Outcomes.
    J Clin Endocrinol Metab.
    Mar 25 2021.
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