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© The Author(s) 2025. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Introduction

Novel therapies are emerging for the prevention of chronic kidney disease (CKD) progression in patients with type 2 diabetes (T2D). Within the FOUNTAIN platform (NCT05526157; EUPAS48148), this real-world study aimed to characterize cohorts of adults with CKD and T2D starting therapy with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in Europe, Japan, and the United States (US) during 2012–2021.

Methods

This multinational, multicohort study was conducted in five data sources: the Danish National Health Registers (DNHR) (Denmark), PHARMO Data Network (PHARMO) (The Netherlands), Valencia Health System Integrated Database (VID) (Spain), Japan Chronic Kidney Disease Database Extension (J-CKD-DB-Ex) (Japan), and Optum’s de-identified Clinformatics® Data Mart Database (CDM) (US). Eligible patients had T2D (defined by data source-specific algorithms) and CKD (based on diagnosis codes, estimated glomerular filtration rate values, and/or urine albumin-to-creatinine ratio) and initiated an GLP-1 RA during 2012–2021. Baseline demographic, lifestyle, and clinical characteristics were analyzed, and treatment patterns were described.

Results

Study cohorts included 18,929 GLP-1 RA initiators in DNHR; 476 in PHARMO; 11,798 in VID; 329 in J-CKD-DB-Ex; and 70,158 in CDM. Across cohorts, mean age ranged from 66.1 years in J-CKD-DB-Ex to 67.9 years in CDM, and between 46.6% (PHARMO) and 59.6% (J-CKD-DB-Ex) of patients were men. There was a steady increase in GLP-1 RA initiators from 2012 (when 1.6–4.8% of GLP-1 RA initiators started therapy) to 2019 (when 19.8–31.5% started therapy). The median duration of initial treatment with a GLP-1 RA ranged from 2.3 months (PHARMO) to 12.4 months (VID). At 1-year follow-up, between 52% (CDM) and 78% (DNHR) of patients were receiving treatment. Findings suggested that GLP-1 RA use was independent of CKD severity.

Conclusions

During 2012–2021, GLP-1 RA use steadily increased across multinational cohorts of patients with T2D and CKD, and persistence with treatment was high. GLP-1 use was independent of CKD severity.

Details

Title
Clinical Profile and Treatment Patterns in Individuals with Type 2 Diabetes and Chronic Kidney Disease Who Initiate a GLP-1 Receptor Agonist: A Multinational Cohort Study
Author
Pladevall-Vila, Manel 1 ; Ziemiecki, Ryan 2 ; Johannes, Catherine B. 3 ; Khan, Anam M. 3 ; Mines, Daniel 4 ; Ebert, Natalie 5 ; Kovesdy, Csaba P. 6 ; Thomsen, Reimar W. 7 ; Baak, Brenda N. 8 ; García-Sempere, Aníbal 9 ; Kanegae, Hiroshi 10 ; Coleman, Craig I. 11 ; Walsh, Michael 12 ; Andersen, Ina Trolle 7 ; Bernal, Clara Rodríguez 9 ; Cabaniñas, Celia Robles 9 ; Christiansen, Christian Fynbo 7 ; Farjat, Alfredo E. 13 ; Gay, Alain 14 ; Gee, Patrick 14 ; Herings, Ron M. C. 8 ; Hurtado, Isabel 9 ; Kashihara, Naoki 15 ; Kristensen, Frederik Pagh Bredahl 7 ; Liu, Fangfang 13 ; Okami, Suguru 13 ; Overbeek, Jetty A. 8 ; Beest, Fernie J. A. Penning-van 8 ; Yamashita, Satoshi 13 ; Yano, Yuichiro 16 ; Layton, J. Bradley 2 ; Vizcaya, David 13 ; Oberprieler, Nikolaus G. 13 

 RTI Health Solutions, Barcelona, Spain; Henry Ford Health System, The Center for Health Policy and Health Services Research, Detroit, USA (GRID:grid.239864.2) (ISNI:0000 0000 8523 7701) 
 RTI Health Solutions, Research Triangle Park, USA (GRID:grid.416262.5) (ISNI:0000 0004 0629 621X) 
 RTI Health Solutions, Waltham, USA (GRID:grid.416262.5) (ISNI:0000 0004 0629 621X) 
 Henry Ford Health System, The Center for Health Policy and Health Services Research, Detroit, USA (GRID:grid.239864.2) (ISNI:0000 0000 8523 7701) 
 Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662) 
 University of Tennessee Health Science Center, Division of Nephrology, Department of Medicine, Memphis, USA (GRID:grid.267301.1) (ISNI:0000 0004 0386 9246) 
 Aarhus University and Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark (GRID:grid.7048.b) (ISNI:0000 0001 1956 2722) 
 PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands (GRID:grid.418604.f) (ISNI:0000 0004 1786 4649) 
 Health Services Research and Pharmacoepidemiology Unit, Fisabio, Spain (GRID:grid.428862.2) (ISNI:0000 0004 0506 9859) 
10  Genki Plaza Medical Centre for Health Care, Tokyo, Japan (GRID:grid.512765.2) 
11  University of Connecticut School of Pharmacy, Storrs, USA (GRID:grid.63054.34) (ISNI:0000 0001 0860 4915); Hartford Hospital, Evidence-Based Practice Center, Hartford, USA (GRID:grid.277313.3) (ISNI:0000 0001 0626 2712) 
12  McMaster University, Division of Nephrology, Department of Medicine, Hamilton, Canada (GRID:grid.25073.33) (ISNI:0000 0004 1936 8227) 
13  Bayer AG, Leverkusen, Germany (GRID:grid.420044.6) (ISNI:0000 0004 0374 4101) 
14  National Kidney Foundation Advocacy, Richmond, USA (GRID:grid.420044.6) 
15  Kawasaki Medical School, Department of Nephrology and Hypertension, Kurashiki, Japan (GRID:grid.415086.e) (ISNI:0000 0001 1014 2000) 
16  Juntendo University, Department of General Medicine, Faculty of Medicine, Tokyo, Japan (GRID:grid.258269.2) (ISNI:0000 0004 1762 2738) 
Pages
931-954
Publication year
2025
Publication date
May 2025
Publisher
Springer Nature B.V.
ISSN
18696953
e-ISSN
18696961
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3191259915
Copyright
© The Author(s) 2025. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.