The effect of the endothelin receptor antagonist atrasentan on insulin resistance in phenotypic clusters of patients with type 2 diabetes and chronic kidney disease
Authors' conclusion
Atrasentan significantly improved insulin sensitivity in patients with T2D and CKD, especially in those characterized by high insulin resistance (SIRD cluster). Further studies are warranted to investigate the long-term clinical outcomes of atrasentan treatment in these distinct phenotypic clusters.
Study context
- Population
- Patients with T2D and chronic kidney disease (CKD) in the SONAR trial, stratified into four phenotypic clusters: Severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), MOD and mild age-related diabetes (MARD)
- Participants
- 931 patients
- Comparison
- Atrasentan vs placebo, across phenotypic clusters
- Primary endpoint
- Change in insulin resistance (HOMA-IR), compared between phenotypic clusters
Methodological detailsrandomized, placebo-controlled, mixed effects model
- Randomized
- Placebo-controlled
- Mixed effects model
Primary result
As reported in the abstract
SIRD cluster: HOMA-IR reduction, atrasentan vs placebo
26.2%
95% CI 3.8,43.3
SIDD cluster: HOMA-IR reduction, atrasentan vs placebo (95%CI −3.8,35.9); not statistically significant
18.5%
MARD cluster: HOMA-IR reduction, atrasentan vs placebo
12.2%
95% CI −1.7,24.12
MOD cluster: HOMA-IR reduction, atrasentan vs placebo
−5.3%
95% CI −28.9,13.9
Further findings
| Outcome | Reduction in HOMA-IR (%) (95% CI) |
|---|---|
| Reduction in HOMA-IR, overall population | 12.9 (3.5,21.4) |
Original publication
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