Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Asan Diabetes Center, Asan Medical Center, Seoul, Republic of Korea.
Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea.
Clin Ther. 2024 Sep;46(9):683-688. doi: 10.1016/j.clinthera.2024.06.024. Epub 2024 Jul 27.
Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist that is not cleared by the kidneys and has proven efficacy and safety in patients with diabetic kidney disease. We aimed to evaluate the 1-year efficacy of dulaglutide in patients with diabetic kidney disease who have used the drug for more than 1 year.
This retrospective, observational study comprised 131 patients with an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m who had received dulaglutide for more than one year between June 2016 and May 2023. The primary outcome measures were changes in glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and body weight from baseline to the 12-month follow-up, with assessments performed at six-month intervals. Subgroup analyses were conducted based on age, sex, baseline body mass index, FPG, and HbA1c, and insulin administration at baseline and last follow-up.
The mean age was 60.0 ± 10.2 years, and 61.1% of the participants were males. Baseline HbA1c, FPG, and body weight were 9.1% (76.0 mmol/mol), 186.8 mg/dL, and 79.3 kg, respectively. Dulaglutide significantly reduced HbA1c, FPG, and body weight from baseline to the 12-month follow-up (mean ± standard error: -1.2 ± 0.1%, -34.8 ± 6.9 mg/dL, and -2.3 ± 0.5 kg, respectively; P < 0.001). Subgroup analysis revealed significant differences in HbA1c reduction based on baseline HbA1c.
Dulaglutide exhibited sustained glucose-lowering and weight-reduction effects during the initial 1 year of treatment in patients with diabetic kidney disease. Altogether, dulaglutide could serve as a favorable long-term therapeutic option for patients with diabetic kidney disease in real-world clinical settings.
度拉鲁肽是一种长效胰高血糖素样肽-1 受体激动剂，不会通过肾脏清除，已被证实对患有糖尿病肾病的患者具有疗效和安全性。我们旨在评估已使用度拉鲁肽治疗 1 年以上的糖尿病肾病患者的 1 年疗效。
这是一项回顾性、观察性研究，共纳入 131 例估算肾小球滤过率（eGFR）<60mL/min/1.73m2的患者，这些患者在 2016 年 6 月至 2023 年 5 月期间使用度拉鲁肽治疗超过 1 年。主要观察终点为从基线到 12 个月随访时糖化血红蛋白 A1c（HbA1c）、空腹血糖（FPG）和体重的变化，每 6 个月评估一次。根据年龄、性别、基线体重指数、FPG 和 HbA1c、基线和最后随访时的胰岛素治疗情况进行亚组分析。
患者的平均年龄为 60.0±10.2 岁，61.1%为男性。基线时 HbA1c、FPG 和体重分别为 9.1%（76.0mmol/mol）、186.8mg/dL 和 79.3kg。度拉鲁肽可显著降低从基线到 12 个月随访时的 HbA1c、FPG 和体重（平均±标准误：-1.2±0.1%、-34.8±6.9mg/dL 和-2.3±0.5kg；P<0.001）。亚组分析显示，HbA1c 降低与基线 HbA1c 有关。
在糖尿病肾病患者中，度拉鲁肽在初始治疗的 1 年内可持续降低血糖和减轻体重。总之，在真实临床环境中，度拉鲁肽可能成为糖尿病肾病患者的一种有利的长期治疗选择。
