Saxagliptin linked to improved albumin/creatinine ratios

(HealthDay)—For patients with type 2 diabetes, saxagliptin is associated with improvement in the albumin/creatinine ratio (ACR), according to a study published online Oct. 17 in Diabetes Care.

Ofri Mosenzon, M.D., from the Hadassah Hebrew University Hospital in Jerusalem, and colleagues studied renal outcomes of 16,492 patients with type 2 diabetes randomized to saxagliptin versus placebo and followed for a median of 2.1 years.

The researchers found that from baseline to the end of the trial, treatment with saxagliptin was associated with improvement in and/or less deterioration in ACR categories for individuals with baseline normoalbuminuria, microalbuminuria, and macroalbuminuria (P = 0.021; P < 0.001; P = 0.049, respectively). The difference in mean ACR change between the saxagliptin and placebo arms was −19.3 mg/g, −105 mg/g, and −245.2 mg/g for estimated glomerular filtration rate (eGFR) of >50 mL/min/BSA, 50≥ eGFR ≥30 mL/min/BSA, and <30 mL/min/BSA, respectively (P = 0.033; P = 0.011; P = 0.086). There was reduction in ACR with saxagliptin on analysis of ACR as a continuous variable. There was no correlation between the change in ACR and that in glycated hemoglobin. The saxagliptin and placebo groups had similar change in eGFR. Similar safety renal outcomes were also seen for the groups.

"Treatment with saxagliptin improved ACR, even in the normoalbuminuric range, without affecting eGFR," the authors write. "The beneficial effect of saxagliptin on albuminuria could not be explained by its effect on glycemic control."

Several authors disclosed financial ties to pharmaceutical companies, including AstraZeneca and Bristol-Myers Squibb, which funded the trial.