Liraglutide may be safe in type 2 diabetes with mild renal impairment

A doctor and patient discuss medicines

Clinical question

In patients with type 2 diabetes and mild renal impairment, is liraglutide safe and effective?

Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog sometimes used in type 2 diabetes to help the body produce more insulin.  This review looked at whether it is safe in people who also have renal impairment.

The evidence

Renal impairment was defined by creatinine clearance.  The outcomes included glycemic control (HbA1c), blood pressure and body weight.

Data from six clinical trials comparing liraglutide with placebo were combined in one meta-analysis.  Patients were stratified as having normal renal function,  “mild renal impairment” or “moderate or severe renal impairment”.

The data showed that patients with mild renal impairment achieved similar glycemic control on liraglutide compared to patients with normal renal function.  However, this was not true for all outcomes.

Appraisal hints

Users of this evidence may wish to consider:

  • Did the review specify its protocol in advance and adhere to it, or were any elements of it “data-driven” or modified in the light of findings?
  • The size, quality and heterogeneity of the six individual studies contributing data to this meta-analysis
  • How much uncertainty there is around these estimates
  • What the findings were for the full range of outcomes specified in the protocol
  • Whether there were any adverse outcomes, particularly in renal function
  • The possibility that other data – published or unpublished – might be relevant to this review.

Reference

Davidson JA, Brett J et al. Mild renal impairment and the efficacy and safety of liraglutide. Endocr Pract. 2011 May-Jun;17(3):345-55.

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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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