Liraglutide Reduces Major Cardiovascular Events In Patients With Chronic Kidney Disease: Results Fro

Introduction: people with type 2 diabetes (T2D) and chronic kidney disease (CKD) are at high risk of cardiovascular (CV) events. We analyzed the effect of liraglutide vs placebo (PBO) on CV outcomes in patients with T2D and CKD in the LEADER trial. Methods: LEADER was a randomized, double-blind, multicenter, CV outcome trial with liraglutide 1.8 mg/day vs PBO, both in addition to standard of care for 3.5-5 years, in 9340 patients with T2D and high CV risk. The primary composite outcome was defined as first occurrence of death from CV causes, non-fatal myocardial infarction, or non-fatal stroke. The expanded composite CV outcome additionally included coronary revascularization, and hospitalization for unstable angina pectoris or hospitalization for heart failure (HF). In this analysis, CV outcomes were assessed in patients with CKD based on estimated glomerular filtration rate (eGFR) (<60 and >=60 mL/min/1.73 m2) and on albuminuria (>=30 mg/g: micro/macroalbuminuria and <30 mg/g: normoalbuminuria). Results: the mean eGFR in patients with baseline eGFR <60 (n=2158) and >=60 mL/min/1.73 m2 (n=7182) was 45.7±10.9 and 90.8±21.6 mL/min/1.73 m2, respectively. Versus PBO, liraglutide was associated with reductions in the risk of the primary composite outcome: hazard ratio (HR) 0.69 (confidence interval [CI] 0.57;0.85) for the eGFR <60 subgroup and HR 0.94 (CI 0.83;1.07) in the eGFR >=60 subgroup. Equivalent reductions in the expanded composite CV outcome were observed (Fig). In the eGFR <60 mL/min/1.73 m2 subgroup, liraglutide significantly reduced the risk of CV death, non-fatal stroke and hospitalization for HF vs PBO (Fig). Liraglutide also reduced the risk of the primary composite outcome, the expanded composite CV outcome and CV death in the micro/macroalbuminuria subgroup vs PBO (Fig). Conclusions: in LEADER, there was a significant reduction of major CV events in patients with CKD.