PMID- 32966971 OWN - NLM STAT- MEDLINE DCOM- 20210913 LR - 20210913 IS - 1421-9670 (Electronic) IS - 0250-8095 (Print) IS - 0250-8095 (Linking) VI - 51 IP - 10 DP - 2020 TI - Exenatide and Renal Outcomes in Patients with Type 2 Diabetes and Diabetic Kidney Disease. PG - 806-814 LID - 10.1159/000510255 [doi] AB - BACKGROUND: Cardiovascular outcomes in clinical trials with type 2 diabetes mellitus (T2DM) patients have shown that glucagon-like peptide-1 receptor agonist can have a beneficial effect on the kidney. This trial aimed to assess the effects of exenatide on renal outcomes in patients with T2DM and diabetic kidney disease (DKD). METHODS: We performed a randomized parallel study encompassing 4 general hospitals. T2DM patients with an estimated glomerular filtration rate (eGFR) >/=30 mL/min/1.73 m2 and macroalbuminuria, defined as 24-h urinary albumin excretion rate (UAER) >0.3 g/24 h were randomized 1:1 to receive exenatide twice daily plus insulin glargine (intervention group) or insulin lispro plus glargine (control group) for 24 weeks. The primary outcome was the UAER percentage change from the baseline after 24 weeks of intervention. The rates of hypoglycemia, adverse events (AEs), and change in eGFR during the follow-up were measured as safety outcomes. RESULTS: Between March 2016 and April 2019, 92 patients were randomized and took at least 1 dose of the study drug. The mean age of the participants was 56 years. At baseline, the median UAER was 1,512.0 mg/24 h and mean eGFR was 70.4 mL/min/1.73 m2. After 24 weeks of treatment, the UAER percentage change was significantly lower in the intervention group than in the control group (p = 0.0255). Moreover, the body weight declined by 1.3 kg in the intervention group (the difference between the 2 groups was 2.7 kg, p = 0.0001). Compared to the control group, a lower frequency of hypoglycemia and more gastrointestinal AEs were observed in the intervention group. CONCLUSION: Exenatide plus insulin glargine treatment for 24 weeks resulted in a reduction of albuminuria in T2DM patients with DKD. CI - The Author(s). Published by S. Karger AG, Basel. FAU - Wang, Xiangyu AU - Wang X AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Zhang, Huijie AU - Zhang H AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Zhang, Qian AU - Zhang Q AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Guan, Meiping AU - Guan M AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Sheng, Shuyue AU - Sheng S AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Mo, Wei AU - Mo W AD - Department of Endocrinology & Metabolism, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China. FAU - Zou, Mengchen AU - Zou M AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Li, Jimin AU - Li J AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Bi, Jianlu AU - Bi J AD - Department of Endocrinology & Metabolism, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China. FAU - Tang, Xianyu AU - Tang X AD - Department of Endocrinology & Metabolism, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Zeng, Huiyan AU - Zeng H AD - Department of Endocrinology & Metabolism, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - He, Jiali AU - He J AD - Department of Endocrinology & Metabolism, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Xu, Gugen AU - Xu G AD - Department of Endocrinology & Metabolism, Guangdong Second Provincial General Hospital, Guangzhou, China. FAU - Li, Ping AU - Li P AD - Department of Endocrinology & Metabolism, Guangdong Second Provincial General Hospital, Guangzhou, China. FAU - Xue, Yaoming AU - Xue Y AD - Department of Endocrinology & Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China, xueyaoming999@126.com. LA - eng PT - Clinical Trial, Phase IV PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20200923 PL - Switzerland TA - Am J Nephrol JT - American journal of nephrology JID - 8109361 RN - 0 (Blood Glucose) RN - 0 (Hypoglycemic Agents) RN - 2ZM8CX04RZ (Insulin Glargine) RN - 9P1872D4OL (Exenatide) SB - IM MH - Albuminuria/blood/diagnosis/*drug therapy/etiology MH - Blood Glucose/analysis/drug effects MH - Diabetes Mellitus, Type 2/complications/*drug therapy MH - Diabetic Nephropathies/blood/diagnosis/*drug therapy/etiology MH - Disease Progression MH - Drug Therapy, Combination/adverse effects/methods MH - Exenatide/*administration & dosage/adverse effects MH - Female MH - Follow-Up Studies MH - Humans MH - Hypoglycemia/blood/chemically induced/diagnosis/epidemiology MH - Hypoglycemic Agents/*administration & dosage/adverse effects MH - Insulin Glargine/administration & dosage/adverse effects MH - Male MH - Middle Aged MH - Treatment Outcome PMC - PMC7677996 OTO - NOTNLM OT - Albuminuria OT - Diabetic kidney disease OT - Exenatide OT - Glucagon-like peptide-1 receptor agonists OT - Type 2 diabetes COIS- The authors have no conflicts of interest to declare. EDAT- 2020/09/24 06:00 MHDA- 2021/09/14 06:00 PMCR- 2020/09/23 CRDT- 2020/09/23 20:08 PHST- 2020/05/19 00:00 [received] PHST- 2020/07/15 00:00 [accepted] PHST- 2020/09/24 06:00 [pubmed] PHST- 2021/09/14 06:00 [medline] PHST- 2020/09/23 20:08 [entrez] PHST- 2020/09/23 00:00 [pmc-release] AID - 000510255 [pii] AID - ajn-0051-0806 [pii] AID - 10.1159/000510255 [doi] PST - ppublish SO - Am J Nephrol. 2020;51(10):806-814. doi: 10.1159/000510255. Epub 2020 Sep 23.