Please use this identifier to cite or link to this item:
Title: Novel Therapies for Kidney Disease in People with Diabetes.
Austin Authors: Khurana, Nayana;James, Steven;Coughlan, Melinda T;MacIsaac, Richard J;Ekinci, Elif I 
Affiliation: School of Nursing, Midwifery and Paramedicine, the University of the Sunshine Coast, Petrie, Queensland, Australia
Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
Department of Diabetes, Monash University, Central Clinical School, Alfred Medical Research Education Precinct, Melbourne, Australia
Department of Medicine, the University of Melbourne, Parkville, Victoria, Australia
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
Issue Date: 2022
Date: 2021-08-30
Publication information: The Journal of clinical endocrinology and metabolism 2022; 107(1): e1-e24
Abstract: The increasing burden of diabetic kidney disease (DKD) has led to the discovery of novel therapies. This review aims to summarise the results of recent clinical trials that test the efficacy of potential therapies for DKD. A systematised narrative review was performed utilising PubMed, Embase (Ovid), CINAHL and Cochrane databases (January 2010-January 2021). Trials included assessed the efficacy of specific medications using renal endpoints in adult participants with either type 1 or 2 diabetes. 53 trials were identified. Large, multinational and high-powered trials investigating sodium-glucose cotransporter-2 inhibitors demonstrated improved renal outcomes, even in patients with established DKD. Trials examining incretin-related therapies also showed some improvement in renal outcomes. Additionally, mineralocorticoid-receptor antagonists exhibited potential with multiple improved renal outcomes in large trials, including those involving participants with established DKD. Atrasentan, baricitinib, ASP8232, PF-04634817, CCX140-B, atorvastatin, fenofibrate, probucol, doxycycline, vitamin D, omega-3 fatty acids, silymarin, turmeric, total glucosides of paeony and tripterygium wilfordii Hook F extract were all associated with some improved renal endpoints, but with need for further exploration. While bardoxolone methyl was associated with a decrease in albuminuria, high rates of cardiovascular adverse effects curtailed further exploration into this agent. Selonsertib, allopurinol, praliciguat, palosuran, benfotiamine and diacerein were not associated with improved renal outcomes. Trials have yielded promising results in the search for new therapies to manage DKD. Sodium-glucose cotransporter-2 inhibitors and incretin-related therapies have demonstrated benefit and were associated with improved cardiovascular outcomes. Mineralocorticoid-receptor antagonists are another class of agents with increasing evidence of benefits.
DOI: 10.1210/clinem/dgab639
ORCID: 0000-0002-8509-2295
Journal: The Journal of Clinical Endocrinology and Metabolism
PubMed URL: 34460928
Type: Journal Article
Subjects: Diabetic kidney disease
Diabetic nephropathy
Type 1 diabetes
Type 2 diabetes
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Apr 19, 2024

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.