Comparison of estimated glomerular filtration rate change with sodium‐glucose cotransporter‐2 inhibitors versus glucagon‐like peptide‐1 receptor agonists among people with diabetes: A propensity‐score matching study

• Published in: Diabetes, obesity & metabolism Vol. 26; no. 6; pp. 2422 - 2430
• Main Authors: Suzuki, Yuta, Kaneko, Hidehiro, Nagasawa, Hajime, Okada, Akira, Fujiu, Katsuhito, Jo, Taisuke, Takeda, Norifumi, Morita, Hiroyuki, Nishiyama, Akira, Gohda, Tomohito, Suzuki, Yusuke, Node, Koichi, Yasunaga, Hideo, Nangaku, Masaomi, Komuro, Issei
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2024; Wiley Subscription Services, Inc
• Subjects: Agonists; chronic kidney disease; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetic Nephropathies - physiopathology; Epidermal growth factor receptors; Female; Glomerular filtration rate; Glomerular Filtration Rate - drug effects; GLP‐1RA; Glucagon; Glucagon-Like Peptide-1 Receptor - agonists; Humans; Hypoglycemic Agents - therapeutic use; Kidneys; Male; Middle Aged; Peptides; Propensity Score; Retrospective Studies; SGLT2 inhibitors; Sodium-glucose cotransporter; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; chronic kidney disease; diabetes; GLP‐1RA; SGLT2 inhibitors
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.15561

Aim To compare the risk of developing kidney outcomes with use of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) versus use of sodium‐glucose cotransporter‐2 (SGLT2) inhibitors among individuals with diabetes. Materials and Methods In this retrospective observational study, we analysed 12 338 individuals with diabetes who newly initiated SGLT2 inhibitors or GLP‐1RAs using data from the JMDC claims database. The primary outcome was change in the estimated glomerular filtration rate (eGFR), estimated using a linear mixed‐effects model. A 1:4 propensity‐score‐matching algorithm was used to compare the changes in eGFR between GLP‐1RA and SGLT2 inhibitor users. Results After propensity‐score matching, 2549 individuals (median [range] age 52 [46–58] years, 80.6% men) were analysed (510 GLP‐1RA new users and 2039 SGLT2 inhibitor new users). SGLT2 inhibitor use was associated with a slower eGFR decline when compared with GLP‐1RA use (−1.41 [95% confidence interval −1.63 to −1.19] mL/min/1.73 m2 vs. −2.62 [95% confidence interval −3.15 to −2.10] mL/min/1.73 m2). Conclusions Our analysis demonstrates the potential advantages of SGLT2 inhibitors over GLP‐1RAs in terms of kidney outcomes in individuals with diabetes.