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.

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.