Diabetes, obesity & metabolismAug 18, 2020

Once-weekly exenatide’s impact on kidney function changes varies with starting kidney risk

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Apr 4, 2026

Abstract

In a study of 3,503 participants, once-weekly exenatide significantly improved (eGFR) slope in those with elevated baseline (UACR).

Exenatide improved eGFR slope by 0.79 mL/min/1.73 m/year in participants with baseline UACR >100 mg/g and by 1.32 mL/min/1.73 m/year in those with UACR >200 mg/g compared to placebo.
No significant improvement in eGFR slope was observed in participants with lower baseline UACR levels.
Exenatide also reduced UACR by 28.2% in participants with baseline UACR >30 mg/g, 22.5% in those with UACR >100 mg/g, and 34.5% in those with UACR >200 mg/g.
The findings suggest potential benefits of exenatide in managing renal function in patients with type 2 diabetes at high risk of renal function loss.

Simplified

The effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on renal outcomes in patients with type 2 diabetes at high cardiovascular risk are modest or neutral. However, GLP-1RAs may confer clinical benefits in those at high risk of progressive renal function loss. We examined the effects of once-weekly exenatide (EQW) on (eGFR) slope and (UACR) as a function of baseline UACR in 3503 EXSCEL participants (23.7%) with eGFR data available and 2828 participants (19.2%) with UACR change data available. EQW improved eGFR slope assessed via mixed model repeated measures, compared with placebo, in participants with baseline UACR >100 mg/g (0.79 mL/min/1.73 m/year [95% confidence interval {CI} 0.24-1.34]) and UACR >200 mg/g (1.32 mL/min/1.73 m/year [95% CI 0.57-2.06]), but not at lower UACR thresholds. EQW reduced UACR, compared with placebo, assessed via analysis of covariance, consistently across subgroups with baseline UACR >30 mg/g (28.2% reduction), baseline UACR >100 mg (22.5% reduction) and baseline UACR >200 mg (34.5% reduction). This post hoc EXSCEL analysis suggests that EQW reduces UACR, with improvement in eGFR slope specifically in participants with elevated baseline UACR. 2 2

Key numbers

0.79 mL/min/1.73 m/year

Increase in Slope

Compared to placebo in participants with baseline >100 mg/g

28.2%

Reduction in

In participants with baseline >30 mg/g

34.5%

Further Reduction in

In participants with baseline >200 mg/g

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Funding

Competing interests

A.B.v.d.A.‐v.d.B. has nothing to disclose. L.E.C., R.C.P., D.W.B. and C.D.S. are employees and/or shareholders of AstraZeneca. D.W.B. is a stockholder of Bristol‐Myers Squibb Company. R.J.M. has received research support and honoraria from AstraZeneca, GlaxoSmithKline plc., and Merck & Co., Inc. R.R.H. reports research support from AstraZeneca, Bayer and Merck Sharp & Dohme, and personal fees from Bayer, Intarcia, Merck Sharp & Dohme, Novartis and Novo Nordisk. H.J.L.H. receives research support from Abbvie, AstraZeneca, Boehringer Ingelheim and Janssen, and has consultancy agreements with AstraZeneca, Bayer, Boehringer Ingelheim, Chinook, CSL Pharma, Gilead, Janssen, Merck, MundiPharma, Mitsubishi Tanabe and Retrophin.

PubMed

Once-weekly exenatide’s impact on kidney function changes varies with starting kidney risk

Abstract

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Competing interests

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