Effects of Dulaglutide and Insulin Glargine on Estimated Glomerular Filtration Rate in a Real-world Setting

The aims of this study were to use real-world treatment results to compare changes in estimated glomerular filtration rate (eGFR) and glycosylated hemoglobin (HbA1c) among patients with type 2 diabetes who initiated treatment with dulaglutide or insulin glargine and to determine the proportions of p...

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Bibliographic Details
Published in:Clinical therapeutics 2018-08, Vol.40 (8), p.1396-1407
Main Authors: Boye, Kristina S., Mody, Reema, Wu, Jianmin, Lage, Maureen J., Botros, Fady T., Woodward, Brad
Format: Article
Language:English
Subjects:
Adults
Calipers
Creatinine
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
dulaglutide
Electronic health records
Electronic medical records
Epidermal growth factor receptors
estimated glomerular filtration rate
Glomerular filtration rate
glycosylated hemoglobin
Hemoglobin
Hypoglycemia
Impairment
Insulin
insulin glargine
Kidney diseases
Laboratories
Laboratory tests
Patients
Reduction
Renal function
Statistical analysis
Therapy
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Summary:The aims of this study were to use real-world treatment results to compare changes in estimated glomerular filtration rate (eGFR) and glycosylated hemoglobin (HbA1c) among patients with type 2 diabetes who initiated treatment with dulaglutide or insulin glargine and to determine the proportions of patients with renal impairment who initiate each treatment. The study used data from the Practice Fusion electronic health records database from October 2013 through June 2017. Adults with type 2 diabetes who initiated dulaglutide or insulin glargine therapy and had multiple recorded serum creatinine and/or HbA1c laboratory test results were included in the study. The dulaglutide cohort (n = 1222) was matched to the insulin glargine cohort (n = 13,869) using Mahalanobis distance matching with propensity score calipers. Multivariable analyses of the matched cohorts of individuals with serum creatinine results (n = 1183 dulaglutide and 1183 insulin glargine) examined the association between intent-to-treat therapy and changes in eGFR. In addition, multivariable analyses were also conducted on a subset of these patients who also had recorded HbA1c tests (n = 1088 dulaglutide and 1088 insulin glargine) to examine the association between changes in HbA1c during the 1 year postperiod. Among patients who initiated dulaglutide therapy, only 0.9% of patients had an index eGFR
ISSN:0149-2918
1879-114X
DOI:10.1016/j.clinthera.2018.07.002