Long-term effects of esaxerenone in patients with type 2 diabetes, diabetic kidney disease, and hypertension (JDDM77)

期刊论文
发表日期：

2024年12月10日

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Daigaku Uchida,
Yasunori Sato,
Azuma Kanatsuka,
Nobuichi Kuribayashi,
Susumu Nakamura,
Shigetake Ko,
Hiroshi Maegawa,
Atsushi Hasegawa,
Daishiro Yamada,
Haruhiko Yoshimura,
Hiroki Yokoyama,
Kentaro Sakai,
Kenichi Kimura,
Mikihiko Kudo,
Yasushi Ishigaki,
Hiroshi Yamaguchi,
Fuminobu Okuguchi,
Nobuki Yano,
Hiroaki Seino,
Takashi Ajihara,
Katsuya Yamazaki,
Yasuko Chiba,
Hiroshi Takamura,
Mitsutoshi Kato,
Naoyuki Yamamoto,
Hajime Maeda,
Hiroshi Takeda,
Keiko Arai,
Kotaro Iemitsu,
Masahiko Takai,
Masato Takaki,
Yuki Kono,
Sumio Kato,
Osamu Sekine,
Mariko Oishi,
Akiko Hosokawa,
Koichi Iwasaki,
Akira Okada,
Hidekatsu Sugimoto,
Kokichi Tanaka,
Masae Minami,
Katsushige Abe,
Noriharu Yagi

摘要

Objectives

This clinical study assessed the three-year, long-term effects of esaxerenone, a non-steroidal aldosterone receptor blocker, on Japanese patients with type 2 diabetes, diabetic kidney disease, and hypertension who were receiving renin-angiotensin system inhibitors.

Materials and methods

Data from a computerized diabetic care database were used to retrospectively compare esaxerenone users (Group A) with non-esaxerenone users (Group B). Propensity score weighting was applied to Group B. The study primarily focused on percent changes in the Urine Albumin-Creatinine Ratio (UACR) from baseline and also examined the estimated Glomerular Filtration Rate (eGFR), blood pressure, serum potassium levels, and HbA1c.

Results

There were 199 patients in Group A and 199 in Group B, matched 1:1 using propensity scores. UACR and blood pressure were significantly lower in Group A than in Group B. Geometric mean percent changes in UACR from baseline between the two groups were as follows: − 62.7% at 1 year (95% Confidence Interval (CI): − 91.0 to − 34.1%), − 48.9% at 2 years (95% CI: − 79.4 to − 19.3%), and − 63.8% at 3 years (95% CI: − 107.4 to − 20.2%). Additionally, the present study examined the impact of combining esaxerenone with SGLT2 inhibitors and GLP-1 receptor agonists and showed consistent effects on UACR irrespective of these medications. Esaxerenone slightly lowered eGFR with a low risk of hyperkalemia but did not adversely impact glucose metabolism.

Conclusions

Esaxerenone exerted antihypertensive and antialbuminuric effects in patients with type 2 diabetes, diabetic kidney disease, and hypertension.