Shalini Kasera
Does CKD modify the effects of GLP-1RA and SGLT2i on bodyweight loss?
Mentor: Strinivasan Beddhu, MD
Background/Purpose:
It is unknown whether bodyweight loss resulting from GLP1-RA or SGLT2i is modified by CKD.
Methods:
We examined whether CKD modified the effects of insulin glargine (IG), SGLT2i, or GLP1-RA on bodyweight, in an active comparator, new user study in veterans with T2D on metformin (N = 148,920) who initiated these agents from 1/1/18-12/31/21. Index date was study drug prescription fill date . Bodyweight change was defined as baseline bodyweight (outpatient value closest and within 1 year prior to index date) minus an average of outpatient bodyweights across 6-month intervals after index date, up to 24 months. Administrative censor date was 3/31/2023. Inverse probability weighted mixed effects models related drug class to 24-month bodyweight change in pairwise comparisons in non-CKD and CKD (baseline eGFR<60) subgroups. Interaction terms tested for effect modification by CKD on drug class-bodyweight change associations.
Results:
Mean age was 64.9±10.7 years. 16.7% had CKD. Baseline bodyweights in IG, SGLT2i, and GLP-1RA were 226±49, 224±46, and 239±52 pounds in non-CKD, and 220±46, 216±43, and 229±48 pounds in CKD. 24-month bodyweight difference for IG versus GLP1-RA was 6.82±0.41 pounds in non-CKD and 6.98±0.88 pounds in CKD (interaction p-value=0.74). Corresponding numbers for IG versus SGLT2i: 6.13±0.33 and 6.09±0.69 pounds (interaction p-value=0.93), and for SGLT2i versus GLP1-RA: 0.69±0.37 and 0.89±0.80 pounds (interaction p-value=0.65).
Conclusion:
Patients lost significantly more weight on GLP1-RA or SGLT2i compared to IG, but there was minimal difference in bodyweight change at 2 years between SGLT2i and GLP1-RA. CKD did not modify weight loss on SGLT2i or GLP1-RA.
