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Review
. 2018 Nov 23:7:F1000 Faculty Rev-1844.
doi: 10.12688/f1000research.16135.1. eCollection 2018.

New hypoglycemic agents and the kidney: what do the major trials tell us?

Brendan Smyth  1 , Vlado Perkovic  1
Affiliations
Review

New hypoglycemic agents and the kidney: what do the major trials tell us?

Brendan Smyth et al. F1000Res. .

Abstract

As the burden of diabetic kidney disease continues to expand, new therapies to preserve renal function or prevent diabetic nephropathy are urgently needed. In the past decade, a number of new hypoglycemic classes have emerged, each with a unique profile of action and benefits. Here we review the impact of glycemic control on renal outcomes and the results of the major clinical trials of glucagon-like peptide 1 (GLP-1) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium-glucose co-transporter 2 (SGLT2) inhibitors. Both GLP-1 agonists and SGLT2 inhibitors consistently demonstrate renal benefits. Further studies of these new agents in different patient groups and in comparison to (or in combination with) other treatments are required to better define their role in combating the burden of diabetic kidney disease.

Keywords: Chronic Kidney Disease; DPP-4; Diabetic nephropathy; GLP-1; SGLT2; alogliptin; canagliflozin; empagliflozin; liraglutide; macroalbuminuria; saxagliptin; semaglutide.

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Conflict of interest statement

Competing interests: Dr Perkovic is a member of Steering Committees for CREDENCE (Chair, funded by Janssen), CARMELINA (co-chair, Boehringer-Ingelheim and Eli Lilly), MARLINA (BI/Lilly), SONAR (Abbvie), TESTING (NHMRC/Pfizer), RESOLVE (NHMRC), ASCEND (GSK) and has received Honoraria/advisory boards from Abbvie, Astellas, Astra Zeneca, Bayer, BMS, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novartis, Novo Nordisk and Servier Competing interests: Itamar Raz was co-PI for SAVOR TIMI 53 and DECLARE TIMI 58 trials.Competing interests: Advisory boards/consultancy: Astra Zeneca, BI-Eli Lilly Alliance, Novo Nordisk, Merck, Sanofi Research Grants: Astra Zeneca, BI-Eli Lilly Alliance, Novo Nordisk, Sanofi All honoraria/funding is directly transferred to Daniël van Raalte's employer, VUMC.

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