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Title: Efficacy and Safety of Liraglutide versus Placebo as Add-on to Glucose Lowering Therapy in Patients with Type 2 Diabetes and Moderate Renal Impairment (LIRA-RENAL): A Randomized Clinical Trial
Authors: Davies, Melanie J.
Bain, S. C.
Atkin, S. L.
Rossing, P.
Scott, D.
Shamkhalova, M. S.
Bosch-Traberg, H.
Syren, A.
Umpierrez, G. E.
First Published: Feb-2016
Publisher: American Diabetes Association
Citation: Diabetes Care, 2016, 39(2), 222-230
Abstract: OBJECTIVE Renal impairment in type 2 diabetes limits available glucose-lowering treatment options. This trial was conducted to establish the efficacy and safety of liraglutide as an add-on to existing glucose-lowering medications in patients with inadequately controlled type 2 diabetes and moderate renal impairment. RESEARCH DESIGN AND METHODS In this 26-week, double-blind trial, 279 patients with HbA1c 7–10%, BMI 20–45 kg/m2, and moderate renal impairment (estimated glomerular filtration rate [eGFR] 30–59 mL/min/1.73 m2; MDRD) were randomized (1:1) to once-daily liraglutide 1.8 mg (n = 140) or placebo (n = 139). RESULTS The estimated treatment difference in HbA1c from baseline to week 26 was −0.66% (−7.25 mmol/mol) (95% CI −0.90 to −0.43 [−9.82 to −4.69]), P < 0.0001). Fasting plasma glucose decreased more with liraglutide (−1.22 mmol/L [−22.0 mg/dL]) than with placebo (−0.57 mmol/L [−10.3 mg/dL], P = 0.036). There was a greater reduction in body weight with liraglutide (−2.41 kg) than with placebo (−1.09 kg, P = 0.0052). No changes in renal function were observed (eGFR relative ratio to baseline: −1% liraglutide, +1% placebo; estimated treatment ratio [ETR] 0.98, P = 0.36). The most common adverse events were gastrointestinal (GI) adverse effects (liraglutide, 35.7%; placebo, 17.5%). No difference in hypoglycemic episodes was observed between treatment groups (event rate/100 patient-years of exposure: liraglutide, 30.47; placebo, 40.08; P = 0.54). The estimated ratio to baseline for lipase was 1.33 for liraglutide and 0.97 for placebo (ETR 1.37, P < 0.0001). CONCLUSIONS Liraglutide did not affect renal function and demonstrated better glycemic control, with no increase in hypoglycemia risk but with higher withdrawals due to GI adverse events than placebo in patients with type 2 diabetes and moderate renal impairment.
DOI Link: 10.2337/dc14-2883
ISSN: 0149-5992
eISSN: 1935-5548
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © American Diabetes Association, 2016. This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes. The American Diabetes Association (ADA), publisher of Diabetes, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version can be found in Diabetes Care, 2016, 39(2), 222-230 in print and online at
Description: Deposited on acceptance in accordance with the Publisher's policy, available at
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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