On 29 August, at the 75th European Society of Cardiology (ESC) conference, during a moderated poster session on the topic of ‘Cardiotoxicity of Drugs and Other Therapies’, Daiki Yoshiura, MD, presented an analysis on glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). Specifically, the study evaluated the efficacy of GLP-1RAs compared to sitagliptin in 30,787 patients with T2DM and CKD using real-world electronic health records from 2018 to 2021. After propensity-score matching 7,729 patients in each group, researchers found that GLP-1RAs were associated with significantly lower rates of all-cause mortality, new incidence of heart failure, severe kidney dysfunction, or haemodialysis within three years. Yoshiura concluded that, in patients with T2DM and CKD, GLP-1RAs were associated with a lower risk of death and worsening of renal function compared to sitagliptin.
GLP-1RAs, especially semaglutide, have emerged as disease-modifying agents in T2D patients with CKD, providing significant reductions in renal and cardiovascular events, and lowering mortality rates. This ESC presentation provides compelling real-world evidence that GLP-1RAs offer a superior efficacy profile, this could drive treatment guideline changes and increase market penetration, especially given the substantial unmet medical need in managing patients with both diabetes and kidney disease.
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The ageing global population will lead to an increase in the prevalence of CKD, leading to an expansion of the market, as well as a growing need for more therapeutic options. However, key opinion leaders (KOLs) interviewed by leading data and analytics company GlobalData have emphasised that the use of generic CKD drugs continues to make it difficult for high-priced branded therapies to fully penetrate the market. An EU KOL stated that: “The theme with these drugs is that they are all out of the range of what people can afford. It depends on the insurance companies, what their criteria are for approving it, and then the company’s willingness to provide it when the appeals are denied.” Therefore, additional real-world data on GLP-1RAs is crucial to facilitate insurance coverage and nephrology adoption.
