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December 13, 2022Frontiers in Endocrinology32 citationsOpen Access

Can glucagon-like peptide-1 receptor agonists cause acute kidney injury? An analytical study based on post-marketing approval pharmacovigilance data

SDShichao DongCSChuan Sun

Key Result

Liraglutide was more strongly associated with acute kidney injury than other GLP-1 receptor agonists, with a reporting odds ratio of 1.50 (95% CI 1.41-1.60).

Study Design

Type

Observational (n=2,670)

Structured PICO

Do different GLP-1 receptor agonists have varying risks of causing acute kidney injury in real-world patients?

P
Population
2,670 patients with acute kidney injury associated with GLP-1 receptor agonist monotherapy reported in the FAERS pharmacovigilance database between 2004 and 2021.
E
Exposure
GLP-1 receptor agonist monotherapy (liraglutide, semaglutide, lixisenatide, exenatide, dulaglutide, albiglutide)
C
Comparator
Other GLP-1 receptor agonists and background FAERS reports (disproportionality analysis)
O
Outcome
Acute kidney injury (AKI) signal detection using reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN)safety

In real-world pharmacovigilance data, liraglutide was associated with a higher reported risk of acute kidney injury compared to other GLP-1 receptor agonists, highlighting the need for renal monitoring in high-risk patients.

Main Result

Odds Ratio: 1.5 (95% CI 1.41–1.6)

Limitations

  • Spontaneous reporting systems cannot proactively collect adverse event information, leading to repeated or omitted reporting.
  • Incomplete information in the reported cases.
  • Unable to investigate the underlying diseases of the cases or obtain the original renal function of the patients to discover the full range of risk factors.
  • Cannot be used to definitively compare absolute safety between GLP-1RAs due to the voluntary nature of adverse event reporting.
  • Self-reporting database cannot proactively collect adverse event information, leading to repeated or omitted reporting
  • Incomplete information in the reported cases
  • Unable to investigate the underlying diseases of the cases or obtain original renal function
  • Short marketing time of GLP-1RA and limited number of reported safety events

Abstract

Clinical studies after marketing have shown that the use of glucagon-like peptide-1 receptor agonist(GLP-1RA) may lead to acute kidney injury(AKI). However, few epidemiological studies have investigated the risk, clinical features, and outcomes of AKI caused by different GLP-1RA. In this study, Adverse Event Reporting System (FAERS) data were used to compare the association between different GLP-1RA and AKI in the real world. Methods: FAERS data from January 2004 to December 2021 were mined using disproportionality analysis and Bayesian analysis to determine the correlation between different GLP-1RA and AKI, and the onset time, mortality, and hospitalization rate of different GLP-1RA were analyzed. Results: We identified 2670 cases of AKI events associated with GLP-1RA, of which liraglutide was the most commonly reported (34.98%). The patients with AKI were mainly males (47.94%), and the age group was mainly 45-84 years old (73.15%). obese patients with weight more than 99kg (24.42%) were more likely to have AKI. According to different signal mining methods, reporting odds ratio (ROR) (1.50, 95% confidence interval =1.41-1.60) and Bayesian confidence Propagation neural network (0.57, 95% confidence interval =0.54), liraglutide was more strongly associated with AKI than other GLP-1RA. The median time to onset of AKI was 63 days quartile range (IQR): 15-458.5 days. In addition, the hospitalization rate and fatality rate of patients with GLP-1RA-related AKI were 45.28% and 4.23% respectively. Conclusions: Based on the data in the FAERS database, we analyzed the risk, onset time, and adverse reaction outcomes of GLP-1RA-induced AKI in detail. The results showed that liraglutide had the highest risk of AKI. From the early stage of treatment, we need to monitor patients' renal function regularly, especially for patients with high kidney risks such as obesity and age.

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Cite This Study

Dong et al. (2022) conducted an observational in Acute kidney injury (n=2,670). Liraglutide vs. Other GLP-1 receptor agonists was evaluated on Association with acute kidney injury (Reporting Odds Ratio) (ROR 1.50, 95% CI 1.41-1.60). Liraglutide was more strongly associated with acute kidney injury than other GLP-1 receptor agonists, with a reporting odds ratio of 1.50 (95% CI 1.41-1.60).

synapsesocial.com/papers/6a734b744ad168cfcf2c1d8bhttps://doi.org/10.3389/fendo.2022.1032199
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