Title

The Effect of Glucagon-like-peptide 1 (GLP-1) Receptor Agonism on Diabetic Kidney Disease
Phase 3 Study of the Effect of Glucagon-like-peptide 1 (GLP-1) Receptor Agonism on Renal Outcomes in Humans With Diabetic Kidney Disease
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    20
Diabetic kidney disease (DKD) is a devastating complication of diabetes, that in it's worst form, can lead to early cardiovascular death or kidney failure. A group of medicines used to treat diabetes, glucagon-like-peptide-1 analogues (GLP-1), may be able to protect people with diabetes from DKD by reducing inflammation in the kidney. This study aims to test this theory by studying the effect of GLP-1 on kidney function in people with diabetes.

To understand how GLP-1 can affect inflammation, the investigators will give a GLP-1 treatment (Liraglutide) to people with DKD and monitor the effect on inflammation and kidney function using blood and urine tests. The investigators will compare these results to patients with DKD who do not receive GLP-1 treatment.

If GLP-1 proves to be effective in reducing inflammation and improving kidney function, then it could be developed as a viable new treatment for people with DKD, and may significantly reduce the disease burden, or the risk of DKD, in people with diabetes. This would be a major advance in the treatment of DKD.
A randomised controlled trial for patients with microalbuminuria and type 2 diabetes. Treatment is 0.6mg of liraglutide and is compared to standard care. Treatment duration is 6 months.
Study Started
Apr 30
2013
Primary Completion
Nov 30
2015
Study Completion
Nov 30
2015
Results Posted
Feb 08
2019
Last Update
Feb 08
2019

Drug Liraglutide

Daily administration of liraglutide for 6 months

  • Other names: Glucagon like peptide 1 receptor agonist, NN2211

Liraglutide Active Comparator

Liraglutide 0.6 mg daily

Control No Intervention

Standard diabetes care including renin angiotensin aldosterone system inhibitor or antagonist

Criteria

Inclusion Criteria:

Type 2 diabetes with a HbA1c of 42-75mmol/mol (6-9%DCCT)
Male or female aged above 30 years
Have a negative pregnancy test at screening (women of child bearing potential only)
Body mass index (BMI) of 25kg/m2 or greater
On a renin-angiotensin system antagonist, at a stable dose, for at least 8 weeks before inclusion into the study
Established microalbuminuria
Estimated glomerular filtration rate (eGFR) 30ml/min/1.73m2 or above by Modification of Diet in Renal Disease (MDRD) formula

Exclusion Criteria:

Patients with any cognitive impediment that preclude the patient from giving free and informed consent
Patients on dipeptidyl peptidase 4 inhibitors or thiazolidinedione treatment
Patients with stage 4-5 renal disease, defined as an eGFR of 30ml/min/1.73m2 or less
Patients who have used a GLP-1 agent in the last 6 months
Female patients of child bearing potential who are pregnant, breastfeeding, or unwilling to practice an acceptable barrier and/or hormonal method of contraception or abstinence during participation in the study
Previous pancreatitis
Hypersensitivity to GLP-1 analogues
Proliferative diabetic retinopathy
Any other contraindications, as per the SmPC for liraglutide
Patients with any other clinical condition or prior therapy that, in the opinion of the investigator, would make the patient unsuitable for the study or unable to comply with the dosing requirements
Concurrent treatment with an investigational drug or participation in another clinical trial
Use of an investigational drug within 4 weeks or 5 half-lives, whichever is longer, preceding the first dose of investigational medicinal product

Summary

Liraglutide

Control

All Events

Event Type Organ System Event Term Liraglutide Control

MCP-1:Creatinine Ratio in Urine

Spot urine sample for MCP-1 and creatinine

Liraglutide

27.9
ng/mmol (Mean)
Standard Deviation: 14.3

Control

24.3
ng/mmol (Mean)
Standard Deviation: 15.4

Urine Albumin:Creatinine Ratio

Spot urine sample for albumin and creatinine

Outcome Measure Data Not Reported

Urinary Albumin Excretion Rate

Albuminuria as Measured by 24 Hour Albumin Excretion Rate

Liraglutide

144.1
µg/min (Mean)
Standard Deviation: 232.6

Control

132.4
µg/min (Mean)
Standard Deviation: 101.3

sCD163 in Serum

Serum sample for sCD163

Liraglutide

82.0
ng/ml (Mean)
Standard Deviation: 34

Control

84.0
ng/ml (Mean)
Standard Deviation: 23

sCD163:Creatinine Ratio in Urine

Spot urine sample for MCP-1 and creatinine

Liraglutide

27.9
pg/mmol (Mean)
Standard Deviation: 14.0

Control

24.3
pg/mmol (Mean)
Standard Deviation: 15.4

Safety in All Participants as Measured by Adverse Event Rate

Adverse event data collection

Outcome Measure Data Not Reported

Total

20
Participants

Age, Continuous

65
years (Mean)
Standard Deviation: 9

BMI

32
kg/m2 (Mean)
Standard Deviation: 5

Diastolic Blood Pressure

81
mmHg (Mean)
Standard Deviation: 10

Duration of diabetes

9
years (Mean)
Standard Deviation: 2

Estimated glomerular filtration rate

74
ml/min/1.73m2 (Mean)
Standard Deviation: 10

HbA1c

53
mmol/mol (Mean)
Standard Deviation: 7

MCP-1:Creatinine Ratio in Urine

27.2
ng/mmol (Mean)
Standard Deviation: 19.6

Race and Ethnicity Not Collected

0
Participants

sCD163:creatinine ratio in urine

44
pg/mmol (Mean)
Standard Deviation: 51

sCD163 in serum

100
ng/ml (Mean)
Standard Deviation: 45

Systolic blood pressure

138
mmHg (Mean)
Standard Deviation: 17

Urinary albumin excretion rate

114.9
µg/min (Mean)
Standard Deviation: 123.7

Region of Enrollment

Sex: Female, Male

Overall Study

Liraglutide

Control

Drop/Withdrawal Reasons

Control