Diabetologie und Stoffwechsel 2023; 18(S 01): S61
DOI: 10.1055/s-0043-1767986
Abstracts | DK 2023
Poster
Postersitzung 14

Effects of tirzepatide versus insulin glargine 100U/ml on kidney outcomes in people with type 2 diabetes in SURPASS-4

Hiddo J.L. Heerspink
1   University Medical Center Groningen, University of Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, Netherlands
,
Naveed Sattar
2   University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom
,
Imre Pavo
3   Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana, United States
,
Axel Haupt
3   Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana, United States
,
Kevin L. Duffin
3   Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana, United States
,
Zhengyu Yang
3   Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana, United States
,
Russell John Wiese
3   Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana, United States
,
Katherine R. Tuttle
4   University of Washington, Providence Health Care, Spokane, Washington, United States
,
David Z.I. Cherney
5   Toronto General Hospital, University Health Network, University of Toronto, Division of Nephrology, Department of Medicine, Toronto, Ontario, Canada
,
Jochen Seufert
6   Universitätsklinik Freiburg, Department of Endocrinology and Diabetology, Freiburg, Germany
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Question Does treatment with tirzepatide (TZP 5, 10, 15mg) result in more favourable changes of markers of diabetic kidney disease in people with T2D and high CV risk compared to iGlar?

Methodology We compared progression to pre-specified kidney endpoints between TZP and iGlar. Composite kidney outcomes in SURPASS-4 were analysed: endpoint 1 (eGFR [CKD-EPI] decline ≥ 40% from baseline, renal death, progression to end stage kidney disease, new onset macroalbuminuria) and endpoint 2 (endpoint 1 without new onset macroalbuminuria). Data were examined within the entire study population, and in subgroups defined by baseline SGLT2i use, urine albumin-creatinine ratio (UACR) ≥ 30mg/g, eGFR<60ml/min/1.73m2 and in those at high risk for kidney related outcomes, defined as eGFR<75ml/min per 1.73m2 and macroalbuminuria, or eGFR<45 ml/min per 1.73m2.

Results At baseline, participants (N=1995, age 63.6 years, HbA1c 8.5%) had a mean eGFR of 81.3ml/min per 1.73m2; 17% had eGFR<60 ml/min per 1.73m2, 28% microalbuminuria (UACR 30-300mg/g) and 8% macroalbuminuria (UACR > 300mg/g). During the follow-up to 104 weeks, TZP participants experienced significantly fewer renal outcomes versus iGlar (HR [95% CI]=0.58 [0.43, 0.80]), especially new onset of macroalbuminuria (0.41 [0.26, 0.66]) was reduced, while the new onset of eGFR decline ≥ 40% (0.86 [0.56, 1.33]) was not significantly different between groups.

Conclusions In people with T2D and high cardiovascular risk, TZP reduced markers of diabetic kidney disease risk.



Publication History

Article published online:
02 May 2023

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