Insulin resistance, kidney outcomes and effects of the endothelin receptor antagonist atrasentan in patients with type 2 diabetes and chronic kidney disease
Authors' conclusion
More severe IR is associated with increased risk of cardio-renal outcomes. The endothelin receptor antagonist atrasentan reduced IR.
Study context
- Population
- Patients with T2D and chronic kidney disease (CKD) (eGFR 25–75 mL/min/1.73 m², urine albumin-to-creatinine ratio 300–5000 mg/g), RADAR and SONAR trialsRADAR N = 123
- Comparison
- HOMA-IR and cardio-renal outcomes; atrasentan vs placebo on HOMA-IR
Methodological detailsmultivariable Cox proportional hazards regression, linear mixed effect model
- Multivariable Cox proportional hazards regression
- Linear mixed effect model
Primary result
As reported in the abstract
Association of HOMA-IR (per log-unit increase) with cardio-renal outcomes (SONAR)
Composite cardio-renal outcome, HR
1.32
95%CI 1.09,1.60p = 0.004
Kidney outcome, HR
1.30
95%CI 1.00,1.68p-value = 0.048
Kidney or all-cause mortality outcome, HR
1.25
95%CI 1.01,1.55p-value = 0.037
Further findings
| Outcome | Reduction in HOMA-IR (%) (95% CI) |
|---|---|
| HOMA-IR reduction vs placebo (RADAR) · 12 weeksAtrasentan 0.75 mg/day vs Placebo · reduction with atrasentan | 19.1 (−17.4 to 44.3) |
| HOMA-IR reduction vs placebo (RADAR) · 12 weeksAtrasentan 1.25 mg/day vs Placebo · reduction with atrasentan | 26.7 (−6.4 to 49.5) |
| HOMA-IR reduction vs placebo (SONAR)Reduction with atrasentan | 9.6 (0.6–17.9) |
Original publication
Insulin resistance, kidney outcomes and effects of the endothelin receptor antagonist atrasentan in patients with type 2 diabetes and chronic kidney disease. Cardiovasc Diabetol. Published 16 September 2023. doi:10.
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