Mounjaro Linked to Reduced Kidney Risk in Type 2 Diabetes


The recently approved type 2 diabetes drug Mounjaro (tirzepatide) is linked to improved kidney function in people with new-onset macroalbuminuria (protein in the urine), according to a new study presented at the 2022 American Diabetes Association (ADA) Scientific Sessions, and described in an article at MedPage Today.

Mounjaro, which was approved in May 2022 by the U.S. Food and Drug Administration (FDA), is the first GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist approved in the United States. It is injected weekly at a dose of 5, 10, or 15 milligrams. While there are several other drugs available that act only as a GLP-1 agonist — including Byetta and Bydureon (exenatide), Ozempic and Rybelsus (semaglutide), Victoza (liraglutide), Trulicity (dulaglutide), and Adlyxin (lixisenatide) — Mounjaro activates receptors for two different hormones, GIP and GLP-1. GLP-1 agonists are considered some of the most effective drugs for type 2 diabetes, and have been linked to several other health benefits — including a lower risk of death in people with kidney disease and a lower risk for glaucoma (a vision-threatening eye disorder).

For the latest study, researchers compared the effects of taking Mounjaro or daily insulin glargine (a long-acting insulin) in people with type 2 diabetes who were considered to be at higher risk for heart disease, based on risk factors like obesity or high blood pressure. Participants were randomly assigned to one of these two treatments, and were followed for up to 104 weeks.

Compared with participants who took insulin glargine, those who took Mounjaro were 41% less likely to experience a combined kidney outcome — either a decline in eGFR (a measure of kidney function) of 40% or more, progression to end-stage kidney disease, new-onset macroalbuminuria, or death from kidney-related causes.

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Mounjaro linked to reduced new-onset macroalbuminuria

When the researchers broke down each of these outcomes, though, they found that the improvement from taking Mounjaro was significant only in the area of reducing new-onset macroalbuminuria — cutting this risk for 59%. While these were small improvements in some of the other areas, they didn’t reach the level of statistical significance — meaning that they could have been due to chance.

Importantly, the researchers also found that the reduced risk for macroalbuminuria only applied to participants who had not previously been taking an SGLT2 inhibitor such as Farxiga (dapagliflozin), Invokana (canagliflozin), or Jardiance (empagliflozin). While participants who had been taking an SGLT2 inhibitor before the start of the study saw no significant kidney benefit from taking Mounjaro compared with taking insulin glargine, participants who hadn’t been taking an SGLT2 inhibitor and were assigned to take Mounjaro experienced a 63% lower risk for new-onset macroalbuminuria compared with those assigned to take insulin.

The researchers concluded that taking Mounjaro may help improve kidney function in some people with type 2 diabetes, while noting that future studies should examine the effects of taking this drug in people with type 2 diabetes and chronic kidney disease.

Want to learn more about keeping your kidneys healthy with diabetes? Read “Managing Diabetic Kidney Disease,” “How to Keep Your Kidneys Healthy,” “Protecting Your Kidneys,” and “Kidney Disease: Your Seven-Step Plan for Prevention.”

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