Abstract: TH-PO1059
Does CKD Modify the Effects of Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RAs) and SGLT2 Inhibitors on Weight Loss?
Session Information
- CKD: Therapeutic Advances
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Kasera, Shalini, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Hartsell, Sydney Elizabeth, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Wei, Guo, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Singh, Ravinder, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Nevers, Mckenna R., The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Sarwal, Amara, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Chakravartula, Akhil Ramanujam, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Katkam, Niharika, The University of Utah School of Medicine, Salt Lake City, Utah, United States
- Beddhu, Srinivasan, The University of Utah School of Medicine, Salt Lake City, Utah, United States
Background
It is unknown whether weight loss resulting from a GLP1-RA or SGLT2i is modified by the presence of CKD.
Methods
In an active comparator, new user study, we examined the effects of CKD status on weight loss in veterans with T2D on metformin who began insulin glargine (IG), SGLT2i or GLP1-RA from 1/1/18 to 12/31/21. Index date was the date of initial drug prescription. Outpatient weight closest to the index date and within 1 year prior was defined as baseline weight. Weight change after drug initiation was defined as the difference between baseline weight and an average of all outpatient weights across 6 month intervals after the index date up to 24 months. Follow-up was until 3/31/2023 or 24 months after index date, whichever was earlier. Inverse probability weights (IPW) for each pairwise drug comparison resulted in balance of baseline variables across the drug classes. In IPW mixed effects models, study drug classes were related to weight change at 24 months in pairwise comparisons in non-CKD and CKD (eGFR <60) subgroups. Effect modification was tested by comparing the regression coefficients for each of the pairwise comparisons in non-CKD and CKD subgroups.
Results
Out of 148,920 included veterans, 5.4% were female, 76.1% were white with mean age 64.9±10.7 years, baseline eGFR 80±20 and 16.7% with CKD. The figure shows weight loss at 6 month intervals by drug class and CKD status and the table shows mixed effects model results.
Conclusion
Patients lost significantly more weight on GLP1-RA or SGLT2i compared to insulin glargine, but there was minimal difference in weight change at 2 years between SGLT2i and GLP1-RA. CKD status did not modify weight loss on SGLT2i or GLP1-RA.
| Pairwise Comparison | Weight Difference at 24 Months (pounds) in Non-CKD Subgroup | Weight Difference at 24 Months (pounds) in CKD subgroup | Interaction P-Value for CKD Status on Drug-Based Weight Change |
| IG v. GLP1-RA | 6.82(6.41, 7.22) | 6.98(6.10, 7.87) | 0.74 |
| IG v. SGLT2i | 6.13(5.80, 6.46) | 6.09(5.40, 6.79) | 0.93 |
| SGLT2i v. GLP1-RA | 0.69(0.32, 1.06) | 0.89(0.09, 1.70) | 0.65 |
Funding
- NIDDK Support