Influence of Combination Therapy with Dulaglutide or Liraglutide and SGLT2 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Post-hoc Analysis of the RECAP Study.

Mar 19, 2025The Tokai journal of experimental and clinical medicine

Effects of Combining Dulaglutide or Liraglutide with SGLT2 Inhibitors on Kidney Health in People with Type 2 Diabetes

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Abstract

The incidence of renal composite outcomes was not significantly different between patients treated with SGLT2 inhibitors followed by GLP1 receptor agonists and vice versa.

Combination therapy with SGLT2 inhibitors and GLP1 receptor agonists may not be influenced by the order of medication administration in patients with type 2 diabetes.
No significant difference was observed in renal composite outcomes between dulaglutide and liraglutide users.
Liraglutide users were associated with a 2.63-fold increased odds of experiencing a ≥ 30% decline in kidney function compared to dulaglutide users.
Liraglutide users also showed a significantly larger reduction in albuminuria, with an odds ratio of 0.44.

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OBJECTIVE: We report that the effect of combination therapy with SGLT2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1Ra) on renal composite outcomes is not affected by the preceding drug in patients with type 2 diabetes (T2D). In this study, we performed a post-hoc analysis of dulaglutide and liraglutide users and investigated the differences between GLP1Ra.

METHODS: We analyzed 266 patients treated with an SGLT2i followed by dulaglutide or liraglutide and 194 treated with dulaglutide or liraglutide followed by an SGLT2i. In addition, we analyzed dulaglutide users (n = 246) and liraglutide users (n = 214). Renal composite outcome was defined as the progression of albuminuria and/or a ≥ 30% eGFR decline.

RESULTS: The incidence of renal composite outcomes in the SGLT2i-preceding and GLP1Ra (dulaglutide or liraglutide)-preceding groups was not significantly different. It also did not differ between the dulaglutide and liraglutide users. The incidence of ≥ 30% eGFR decline was more frequent in liraglutide users, with an odds ratio of 2.63 (95% confidence interval: 1.07-6.45, p = 0.04), with a significantly larger decrease in albuminuria in liraglutide users, with an odds ratio of 0.44 (95% confidence interval: 0.04-0.85, p = 0.03).

CONCLUSIONS: Dulaglutide and liraglutide may have different effects on albuminuria and the kidney function in combination with SGLT2i.

Influence of Combination Therapy with Dulaglutide or Liraglutide and SGLT2 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Post-hoc Analysis of the RECAP Study.

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