GLP-1 drugs may help slow kidney disease in people with these disorders: Study

The complications of lupus, the autoimmune disorder is not easy to tackle, especially due to the deterioration in kidney health in patients suffering from this. Systemic lupus erythematosus (SLE) and lupus nephritis patients face high cardiovascular and kidney disease complications. As per National Institutes of Health, kidney disease caused by lupus may get worse over time and lead to kidney failure. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has emerged as a powerful ally in slowing down progression of kidney disease in these patients, as per two studies presented at the 2024 American College of Rheumatology (ACR) Annual Meeting.Originally developed for type 2 diabetes and obesity, GLP-1 medications are showing promise in reducing inflammation, slowing kidney disease progression, and lowering the risk of severe cardiovascular events in lupus patients.“The risk of cardiovascular disease is thought to be at least double that for people with lupus…and we know the risk of progressing to end stage renal disease [ESKD] for patients with lupus nephritis can be as high as 10%-30%, so there’s clearly a major unmet need for new treatments and approaches to improve these outcomes, perhaps with adjunctive treatment beyond our typical immunosuppressive therapy,” April Jorge, MD, of Massachusetts General Hospital, Boston, said at the American College of Rheumatology (ACR) 2024 Annual Meeting. Using the data from the US multicenter electronic health record database TriNetX, Jorge presented findings from a study, and showed how in patients who had both Type 2 diabetes and SLE, those using GLP-1 RAs had lower risks for major adverse cardiac events (MACE), venous thrombosis, kidney disease progression, and all-cause mortality, compared with those using a different class of type 2 diabetes medication. In the second study using TriNetX, Anna-Kay Palmer, MD, a third-year internal medicine resident at Jefferson Einstein Hospital, Philadelphia, explained that GLP-1 RAs reduced the risk of progression to ESKD in patients with lupus nephritis, potentially due to reduction in pro-inflammatory mediators.The patients with lupus were not included in this trial and the study aimed at investigating the potential impact of these medications on cardiovascular and kidney health SLE and lupus nephritis patients.The study involved 96,511 patients with both systemic lupus erythematosus (SLE) and type 2 diabetes (T2D) who had not yet developed end-stage kidney disease (ESKD). Out of these, 29,177 patients had lupus nephritis. Patients using GLP-1 receptor agonists (GLP-1 RAs) versus those using dipeptidyl peptidase 4 inhibitors (DPP4i) for diabetes treatment were compared. The analysis included 25,838 SLE patients (910 on GLP-1 RAs) and 12,387 lupus nephritis patients (267 on GLP-1 RAs). The study found that GLP-1 RAs could help cut major adverse cardiac events (MACE), including myocardial infarction, stroke, and heart failure. It was also found that kidney disease progression and all-cause mortality were also majorly reduced in the GLP-1 RA group. In case of lupus nephritis patients, both cardiac and kidney risks were lower.