What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Type 2 diabetes and prevalent albuminuria (n=217). Intervention: Linagliptin vs. Placebo. Primary outcome: percentage change in geometric mean UACR from baseline to week 24 (between-group difference -28%, 95% CI -47 to -2, p=0.0357).

What question did this study set out to answer?

To evaluate whether the dipeptidyl peptidase-4 inhibitor linagliptin reduces urinary albumin excretion when added to standard renin-angiotensin-aldosterone system (RAAS) inhibition in patients with type 2 diabetes and renal dysfunction.

September 12, 2013Diabetes CareOpen Access

Linagliptin Lowers Albuminuria on Top of Recommended Standard Treatment in Patients With Type 2 Diabetes and Renal Dysfunction

View Full Paper

Ask AI

Bookmark

Key result

Linagliptin added to stable RAAS inhibitors significantly reduced albuminuria compared to placebo in patients with type 2 diabetes and renal dysfunction (between-group difference -28%; 95% CI -47 to -2; P=0.0357).

Why the study?

Does linagliptin reduce albuminuria in patients with type 2 diabetes and prevalent albuminuria receiving stable doses of RAAS inhibitors?

Key Points

To evaluate whether the dipeptidyl peptidase-4 inhibitor linagliptin reduces urinary albumin excretion when added to standard renin-angiotensin-aldosterone system (RAAS) inhibition in patients with type 2 diabetes and renal dysfunction.
Pooled analysis of four 24-week, randomized, double-blind, placebo-controlled, phase III trials.
Included 217 individuals with type 2 diabetes and prevalent albuminuria (UACR 30–3,000 mg/g) receiving stable RAAS inhibitors, randomized to linagliptin 5 mg/day (n=162) or placebo (n=55).
Geometric mean UACR at week 24 decreased by 32% (95% CI, -42 to -21; P < 0.05) with linagliptin versus 6% (95% CI, -27 to +23) with placebo, reflecting a significant between-group reduction of 28% (95% CI, -47 to -2; P = 0.0357).
Linagliptin significantly reduced HbA1c compared to placebo by -0.61% (-6.7 mmol/mol; 95% CI, -0.88 to -0.34; P < 0.0001).
The reduction in albuminuria with linagliptin was independent of patient race, baseline or post-treatment HbA1c, and systolic blood pressure values.

Study Design

Type

Meta-Analysis (n=217)

Blinding

double-blind

Randomization

randomized

Structured PICO

Does linagliptin reduce albuminuria in patients with type 2 diabetes and prevalent albuminuria receiving stable doses of RAAS inhibitors?

Population

217 subjects with type 2 diabetes and prevalent albuminuria receiving stable doses of RAAS inhibitors, randomized to linagliptin or placebo and followed for 24 weeks.

Intervention

Linagliptin 5 mg/day added to stable doses of RAAS inhibitors for 24 weeks

Comparator

Placebo added to stable doses of RAAS inhibitors for 24 weeks

Outcome

Percentage change in geometric mean UACR from baseline to week 24surrogate

Main Result

Mean Difference: -28 (95% CI -47–-2)

Absolute Event Rate: -32% vs -6%

p-value: p=0.0357

Linagliptin added to stable RAAS inhibitors significantly reduced albuminuria in patients with type 2 diabetes and renal dysfunction, independent of changes in glucose or blood pressure.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports linagliptin addition to RAAS inhibitors for albuminuria reduction in type 2 diabetes; extends randomized evidence independent of glycemic or BP effects.

Cite This Study

Groop et al. (2013) conducted a meta-analysis in Type 2 diabetes and prevalent albuminuria (n=217). Linagliptin vs. Placebo was evaluated on percentage change in geometric mean UACR from baseline to week 24 (between-group difference -28%, 95% CI -47 to -2, p=0.0357). Linagliptin added to stable RAAS inhibitors significantly reduced albuminuria compared to placebo in patients with type 2 diabetes and renal dysfunction (between-group difference -28%; 95% CI -47 to -2; P=0.0357).

synapsesocial.com/papers/6a7b00369092edbae3f3c6ec https://doi.org/10.2337/dc13-0323

View Full Paper

Ask AI

Bookmark

Implication

Supports linagliptin addition to RAAS inhibitors for albuminuria reduction in type 2 diabetes; extends randomized evidence independent of glycemic or BP effects.

Linagliptin Lowers Albuminuria on Top of Recommended Standard Treatment in Patients With Type 2 Diabetes and Renal Dysfunction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Linagliptin Lowers Albuminuria on Top of Recommended Standard Treatment in Patients With Type 2 Diabetes and Renal Dysfunction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider