Table 1: Summary of clinical trials evaluating the use of GLP-1 agonists to treat diabetes in patients with CKD.

Drug/Trial Baseline mean GFR (SD) mL/min/1.73 m2 Baseline median UACR mg/g Baseline mean A1C % Composite Kidney Outcome GFR Change UACR Change Body weight change

Liraglutide LEADER [9]

 

 

80

20.7% GFR 30-59

2.4% GFR < 30

26.3% had macroalbuminuria

10.5% had microalbuminuria

 

8.7

 

 

22% reduction

 

 

-7.44/36 months

 

 

17% reduction

26% reduction in new onset macroalbuminuria

 

-2.3 kg

 

 

Liraglutide LIRA-RENAL [11] 45.4 ± 0.23

43.6% GFR 30-45

55.7% GFR 45-59

55.5 ± 7.58 8.1 ± 0.8 No composite -0.35/26 weeks 13% reduction -2.4 kg
Dulaglutide Tuttle 2017 [13] 89.4 ± 17.1 8.9 (4.4-23.9) 7.6-8.5 across 9 studies No composite No significant change in GFR -16.7% vs. -10.0% for placebo

-20.0% vs. -12.5% for active comparator

-20.0% vs. -9.4% for insulin glargine.

Not reported
Dulaglutide AWARD7 Abstract ADA 2017 [14] 38.3 ± 12.8 200 8.6 No composite for kidney events -0.4 for 0.75 mg dose -0.1 for 1.5 mg dose

-1.9 for insulin glargine

-26.7% for 0.75 mg -27.7% for 1.5 mg

-16.4% in insulin glargine

-2.8 kg
EXSCEL Exenatide ER [15] 29.0% GFR > 90

49.7% GFR 60-89

21.2% GFR 30-59

0.1% GFR < 30

Not reported 8.0 No composite for kidney events Percentage of patients discontinuing due to eGFR < 30 mL/min/1.73 m2

1.1% vs. 1.3% placebo

ESRD 0.7 versus 0.9% in placebo

Microalbuminuria 7.2 versus 7.5% in placebo

Macroalbuminuria 2.2 versus 2.8% in placebo

-1.27 kg

GFR: Glomerular Filtration Rate; UACR: Urinary Albumin to Creatinine Ratio; kg: Kilogram; ADA: American Diabetes Association; ER: Extended Release.