Exenatide and sitagliptin are not associated with increased risk of acute renal failure: a retrospective claims analysis

Pendergrass, Merri; Fenton, Cynthia; Haffner, Steve M.; Chen, W.

doi:10.1111/j.1463-1326.2012.01567.x

Cited by 48 publications

(35 citation statements)

References 10 publications

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“…Also, no significant difference was seen between the exenatide and pooled comparator (placebo and insulin) groups (95% CI: -0.98 to 0.96) [152]. Further analyses have shown that there was no difference in the adjusted risk for acute kidney injury among T2D patients taking exenatide compared with patients receiving other drugs (hazard ratio (HR): 0.77, 95% CI: 0.42-1.41, p = 0.40) [153].…”

Section: Renal Effectsmentioning

confidence: 99%

Adverse Effects of GLP-1 Receptor Agonists

2014

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■ AbstractGlucagon-like peptide-1 (GLP-1) receptor agonists are a class of injective anti-diabetic drugs that improve glycemic control and many other atherosclerosis-related parameters in patients with type 2 diabetes (T2D). However, the use of this relatively new class of drugs may be associated with certain adverse effects. Concerns have been expressed regarding the effects of these drugs on pancreatic and thyroid tissue, since animal studies and analyses of drug databases indicate an association of GLP-1 receptor agonists with pancreatitis, pancreatic cancer, and thyroid cancer. However, several meta-analyses failed to confirm a cause-effect relation between GLP-1 receptor agonists and the development of these adverse effects. One benefit of GLP-1 receptor agonists is that they do not cause hypoglycemia when combined with metformin or thiazolidinediones, but the dose of concomitant sulphonylurea or insulin may have to be decreased to reduce the risk of hypoglycemic episodes. On the other hand, several case reports have linked the use of these drugs, mainly exenatide, with the occurrence of acute kidney injury, primarily through hemodynamic derangement due to nausea, vomiting, and diarrhea. The most common symptoms associated with the use of GLP-1 receptor agonists are gastrointestinal symptoms, mainly nausea. Other common adverse effects include injection site reactions, headache, and nasopharyngitis, but these effects do not usually result in discontinuation of the drug. Current evidence shows that GLP-1 receptor agonists have no negative effects on the cardiovascular risk of patients with T2D. Thus, GLP-1 receptor agonists appear to have a favorable safety profile, but ongoing trials will further assess their cardiovascular effects. The aim of this review is to analyze critically the available data regarding adverse events of GLP-1 receptor agonists in different anatomic systems published in Pubmed and Scopus. Whenever possible, certain differences between GLP-1 receptor agonists are described. The review also provides the reader with structured data that compare the rates of the most common adverse effects for each of the various GLP-1 receptor agonists.

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Section: Renal Effectsmentioning

confidence: 99%

Adverse Effects of GLP-1 Receptor Agonists

2014

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“…The kidneys are not a major pathway of elimination for liraglutide; however, its use is not recommended with an eGFR ,60 mL/min/1.73 m 2 due to a current lack of data in this population. GLP-1 receptor agonist use has been associated with postmarketing reports of decreased kidney function (98), yet such toxicity has not been observed in clinical trials or population-based observational studies to date (99)(100)(101)(102). The majority of case reports of decreased kidney function with exenatide have involved at least one contributory factor such as congestive heart failure, pancreatitis, infection, and/or the use of concomitant medications such as diuretics, RAAS inhibitors, and nonsteroidal anti-inflammatory drugs (98).…”

Section: Incretinsmentioning

confidence: 99%

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Tuttle

Bakris

Bilous

et al. 2014

American Journal of Kidney Diseases

657

604

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The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included 1) identification and monitoring, 2) cardiovascular disease and management of dyslipidemia, 3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, 4) glycemia measurement, hypoglycemia, and drug therapies, 5) nutrition and general care in advanced-stage chronic kidney disease, 6) children and adolescents, and 7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.

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“…Ретроспективный анализ большой базы данных (491 539 пациентов) не выявил увеличения риска раз-вития острого почечного повреждения (ОПП) на фоне приема эксенатида [69]. Вместе с тем, имеются еди-ничные сообщения о развитии ОПП на фоне лечения эксенатидом.…”

Section: влияние аналогов гпп-1 и ингибиторов дпп-4 на развитие патолunclassified

Incretin-based therapy: renal effects

Korbut¹,

Климонтов²

2016

Diabetes mellitus

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© Сахарный диабет, 2016ерапия, основанная на модификации эффекта инкретиновых гормонов, -сравнительно новое направление в лечении сахарного диабета 2 типа (СД2). Аналоги глюкагоноподобного пептида 1 типа (ГПП-1) и ингибиторы дипептидилпептидазы 4 типа (ДПП-4) обладают широким спектром фармакологиче-ского действия, включающего гликемические и неглике-мические эффекты. В последние годы большой интерес вызывает способность препаратов данных классов вли-ять на развитие осложнений СД. В настоящем обзоре обобщены результаты экспериментальных и клиниче-ских исследований, посвященных изучению эффектов агонистов ГПП-1 и ингибиторов ДПП-4 на структурно-функциональные изменения в почках при СД. Поиск источников проведен в базах данных Medline/PubMed, Scopus, Web of Science, eLibrary, ClinicalTrials.gov, а также в электронных базах материалов конгрессов Американ-ской диабетической ассоциации (ADA) и Европейской ассоциации по изучению сахарного диабета (EASD). Представлены результаты оригинальных исследований и мета-анализов, опубликованных на русском и англий-ском языках, преимущественно в период 2011-2015 гг. Почка как орган-мишень и место деградации инкретиновых гормонов

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Exenatide and sitagliptin are not associated with increased risk of acute renal failure: a retrospective claims analysis

Abstract: Our study revealed an increased incidence of ARF in diabetic versus non-diabetic patients but no association between use of exenatide or sitagliptin and ARF. Because of the limitations of this observational analysis, we cannot exclude the possibility of a very small increased risk.

Cited by 48 publications

References 10 publications

Adverse Effects of GLP-1 Receptor Agonists

Adverse Effects of GLP-1 Receptor Agonists

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Incretin-based therapy: renal effects

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