Effects of Tirzepatide Versus Insulin Glargine on Cystatin C–Based Kidney Function: A SURPASS-4 Post Hoc Analysis

Hiddo J.L. Heerspink; Naveed Sattar; Imre Pavo; Axel Haupt; Kevin L. Duffin; Zhengyu Yang; Russell J. Wiese; Jonathan M. Wilson; Andrea Hemmingway; David Z.I. Cherney; Katherine R. Tuttle

doi:10.2337/dc23-0261

Effects of Tirzepatide Versus Insulin Glargine on Cystatin C–Based Kidney Function: A SURPASS-4 Post Hoc Analysis

Hiddo J.L. Heerspink^*
, Naveed Sattar
, Imre Pavo
, Axel Haupt
, Kevin L. Duffin
, Zhengyu Yang
, Russell J. Wiese
, Jonathan M. Wilson
, Andrea Hemmingway
, David Z.I. Cherney
, Katherine R. Tuttle

^*Corresponding author for this work

Groningen Kidney Center (GKC)

Research output: Contribution to journal › Article › Academic › peer-review

36 Citations (Scopus)

112 Downloads (Pure)

Abstract

OBJECTIVE Tirzepatide reduces HbA_1c and body weight, and creatinine-based estimated glomerular filtration rate (eGFR) decline. Unlike creatine-derived eGFR (eGFR-creatinine), cystatin C–derived eGFR (eGFR-cystatin C) is unaffected by muscle mass changes. We assessed effects of tirzepatide on eGFR-creatinine and eGFR-cystatin C.

RESEARCH DESIGN AND METHODS Our primary outcome was eGFR change from baseline at 52 weeks with pooled tirzepatide (5, 10, and 15 mg) and titrated insulin glargine in adults with type 2 diabetes and high cardiovascular risk (SURPASS-4).

RESULTS Least squares mean (SE) eGFR-creatinine (mL/min/1.73 m²) changes from baseline with tirzepatide and insulin glargine were 22.5 (0.38) and 23.9 (0.38) (between-group difference, 1.4 [95% CI 0.3–2.4]) and 23.5 (0.37) and 25.3 (0.37) (between-group difference, 1.8 [95% CI 0.8–2.8]) for eGFR-cystatin C. Baseline, 1-year, and 1-year change from baseline values significantly correlated between eGFR-cystatin C and eGFR-creatinine. Measures of eGFR changes did not correlate with body weight changes.

CONCLUSIONS Tirzepatide slows the eGFR decline rate, supporting a kidney-protective effect.

Original language	English
Pages (from-to)	1501-1506
Number of pages	6
Journal	Diabetes Care
Volume	46
Issue number	8
DOIs	https://doi.org/10.2337/dc23-0261
Publication status	Published - Aug-2023

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@article{38399e2918104062a4b2ede015da9820,

title = "Effects of Tirzepatide Versus Insulin Glargine on Cystatin C–Based Kidney Function: A SURPASS-4 Post Hoc Analysis",

abstract = "OBJECTIVE Tirzepatide reduces HbA1c and body weight, and creatinine-based estimated glomerular filtration rate (eGFR) decline. Unlike creatine-derived eGFR (eGFR-creatinine), cystatin C–derived eGFR (eGFR-cystatin C) is unaffected by muscle mass changes. We assessed effects of tirzepatide on eGFR-creatinine and eGFR-cystatin C. RESEARCH DESIGN AND METHODS Our primary outcome was eGFR change from baseline at 52 weeks with pooled tirzepatide (5, 10, and 15 mg) and titrated insulin glargine in adults with type 2 diabetes and high cardiovascular risk (SURPASS-4). RESULTS Least squares mean (SE) eGFR-creatinine (mL/min/1.73 m2) changes from baseline with tirzepatide and insulin glargine were 22.5 (0.38) and 23.9 (0.38) (between-group difference, 1.4 [95\% CI 0.3–2.4]) and 23.5 (0.37) and 25.3 (0.37) (between-group difference, 1.8 [95\% CI 0.8–2.8]) for eGFR-cystatin C. Baseline, 1-year, and 1-year change from baseline values significantly correlated between eGFR-cystatin C and eGFR-creatinine. Measures of eGFR changes did not correlate with body weight changes. CONCLUSIONS Tirzepatide slows the eGFR decline rate, supporting a kidney-protective effect.",

author = "Heerspink, \{Hiddo J.L.\} and Naveed Sattar and Imre Pavo and Axel Haupt and Duffin, \{Kevin L.\} and Zhengyu Yang and Wiese, \{Russell J.\} and Wilson, \{Jonathan M.\} and Andrea Hemmingway and Cherney, \{David Z.I.\} and Tuttle, \{Katherine R.\}",

note = "Publisher Copyright: {\textcopyright} 2023 by the American Diabetes Association.",

year = "2023",

month = aug,

doi = "10.2337/dc23-0261",

language = "English",

volume = "46",

pages = "1501--1506",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "AMER DIABETES ASSOC",

number = "8",

}

TY - JOUR

T1 - Effects of Tirzepatide Versus Insulin Glargine on Cystatin C–Based Kidney Function

T2 - A SURPASS-4 Post Hoc Analysis

AU - Heerspink, Hiddo J.L.

AU - Sattar, Naveed

AU - Pavo, Imre

AU - Haupt, Axel

AU - Duffin, Kevin L.

AU - Yang, Zhengyu

AU - Wiese, Russell J.

AU - Wilson, Jonathan M.

AU - Hemmingway, Andrea

AU - Cherney, David Z.I.

AU - Tuttle, Katherine R.

PY - 2023/8

Y1 - 2023/8

N2 - OBJECTIVE Tirzepatide reduces HbA1c and body weight, and creatinine-based estimated glomerular filtration rate (eGFR) decline. Unlike creatine-derived eGFR (eGFR-creatinine), cystatin C–derived eGFR (eGFR-cystatin C) is unaffected by muscle mass changes. We assessed effects of tirzepatide on eGFR-creatinine and eGFR-cystatin C. RESEARCH DESIGN AND METHODS Our primary outcome was eGFR change from baseline at 52 weeks with pooled tirzepatide (5, 10, and 15 mg) and titrated insulin glargine in adults with type 2 diabetes and high cardiovascular risk (SURPASS-4). RESULTS Least squares mean (SE) eGFR-creatinine (mL/min/1.73 m2) changes from baseline with tirzepatide and insulin glargine were 22.5 (0.38) and 23.9 (0.38) (between-group difference, 1.4 [95% CI 0.3–2.4]) and 23.5 (0.37) and 25.3 (0.37) (between-group difference, 1.8 [95% CI 0.8–2.8]) for eGFR-cystatin C. Baseline, 1-year, and 1-year change from baseline values significantly correlated between eGFR-cystatin C and eGFR-creatinine. Measures of eGFR changes did not correlate with body weight changes. CONCLUSIONS Tirzepatide slows the eGFR decline rate, supporting a kidney-protective effect.

AB - OBJECTIVE Tirzepatide reduces HbA1c and body weight, and creatinine-based estimated glomerular filtration rate (eGFR) decline. Unlike creatine-derived eGFR (eGFR-creatinine), cystatin C–derived eGFR (eGFR-cystatin C) is unaffected by muscle mass changes. We assessed effects of tirzepatide on eGFR-creatinine and eGFR-cystatin C. RESEARCH DESIGN AND METHODS Our primary outcome was eGFR change from baseline at 52 weeks with pooled tirzepatide (5, 10, and 15 mg) and titrated insulin glargine in adults with type 2 diabetes and high cardiovascular risk (SURPASS-4). RESULTS Least squares mean (SE) eGFR-creatinine (mL/min/1.73 m2) changes from baseline with tirzepatide and insulin glargine were 22.5 (0.38) and 23.9 (0.38) (between-group difference, 1.4 [95% CI 0.3–2.4]) and 23.5 (0.37) and 25.3 (0.37) (between-group difference, 1.8 [95% CI 0.8–2.8]) for eGFR-cystatin C. Baseline, 1-year, and 1-year change from baseline values significantly correlated between eGFR-cystatin C and eGFR-creatinine. Measures of eGFR changes did not correlate with body weight changes. CONCLUSIONS Tirzepatide slows the eGFR decline rate, supporting a kidney-protective effect.

UR - https://www.scopus.com/pages/publications/85166084437

U2 - 10.2337/dc23-0261

DO - 10.2337/dc23-0261

M3 - Article

C2 - 37267479

AN - SCOPUS:85166084437

SN - 0149-5992

VL - 46

SP - 1501

EP - 1506

JO - Diabetes Care

JF - Diabetes Care

IS - 8

ER -

Effects of Tirzepatide Versus Insulin Glargine on Cystatin C–Based Kidney Function: A SURPASS-4 Post Hoc Analysis

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