Latest news with #SGLT2is
Medscape
15-05-2025
- Health
- Medscape
Psoriasis Tied to Kidney Disease in T2D, Despite Treatment
Patients with type 2 diabetes (T2D) who have psoriasis showed an increased risk for renal disease, including diabetic neuropathy, chronic kidney disease (CKD), end-stage renal disease (ESRD), and dialysis despite renoprotective therapy, while CKD risk had increased at 10 years after starting treatment among those receiving biologics. METHODOLOGY: Researchers conducted a retrospective cohort analysis using TriNetX data from 2014-2024, which included patients with T2D who started treatment with angiotensin-converting enzyme inhibitors (ACEis), angiotensin II receptor blockers (ARBs), or sodium-glucose cotransporter-2 inhibitors (SGLT2is). After propensity score matching, 27,044 patients were included in two cohorts — with and without psoriasis, diagnosed before starting renoprotective therapy. A total of 7771 patients with psoriasis received biologics, including interleukin (IL)-23, IL-17, IL-12/23, or tumor necrosis factor (TNF) alpha inhibitors. Study outcomes were diabetic nephropathy, CKD, ESRD, and need for dialysis at 3, 5, and 10 years. TAKEAWAY: At 3 years, patients with psoriasis demonstrated a significantly higher risk for diabetic nephropathy (absolute risk increase [ARI], 1.31; P < .0001), CKD (ARI, 1.80; P < .0001), ESRD (ARI, 0.38; P < .0001), and dialysis (ARI, 0.28; P < .0001). < .0001), CKD (ARI, 1.80; < .0001), ESRD (ARI, 0.38; < .0001), and dialysis (ARI, 0.28; < .0001). The increased risk persisted at 5 years (ARI, 2.02, 3.28, 0.58, 0.42, respectively; all P < .0001), and at 10 years (ARI, 3.30, 6.33, 0.94, 0.63, respectively; all P < .0001). < .0001), and at 10 years (ARI, 3.30, 6.33, 0.94, 0.63, respectively; all < .0001). Patients with psoriasis who received biologics showed a higher risk for CKD at 10 years despite renoprotective therapy ( P < .0001) than those without psoriasis. IN PRACTICE: 'Psoriasis may trigger a T-helper-17-driven inflammatory response, leading to the production of cytokines such as IL-17, IL-12/23, and TNF,' which induce renal inflammation, and this process is 'not targeted by ACEis, ARBs, or SGLT2is,' which may explain the persistently elevated CKD risk in patients with both T2DM and psoriasis, according to the study authors. They added that the findings support earlier evidence that 'biologics do not ameliorate the deterioration of renal function' in those with existing renal issues and a prospective study is needed to confirm these associations. SOURCE: The study was led by Tarun Sontam, Texas A&M School of Medicine, Dallas, Texas, and was published online on May 7 in the Journal of the American Academy of Dermatology . LIMITATIONS: The study did not account for psoriasis severity or duration and adherence to renoprotective therapy. The authors noted that uncontrolled factors might influence the findings. DISCLOSURES: The authors reported having no conflicts of interest. The study had no funding source.
The Independent
07-04-2025
- Health
- The Independent
Weight loss jab Wegovy could lower your risk of dementia
Obesity and diabetes drugs, particularly semaglutides like Wegovy and Ozempic, may reduce a person's risk of dementia, a new study suggests. Researchers found these medications show promise in lowering the risk of cognitive impairment. Experts say further research is needed to understand the drugs' effects on the brain and the mechanisms behind this potential protective effect. The US study analysed data from type 2 diabetes patients taking either GLP-1 receptor agonists (GLP-1RAs) or sodium-glucose cotransporter-2inhibitors (SGLT-2i). GLP-1RAs like semaglutide work by suppressing appetite, while SGLT-2i reduce glucose reabsorption in the kidneys. Semaglutide is available as Wegovy and Ozempic injections, and also as Rybelsus tablets. The study's findings indicate a potential link between these medications and a lower risk of dementia. Wegovy was approved to tackle weight loss on the NHS in 2023, while Ozempic and Rybelus are available on the health service as treatments for type 2 diabetes. The study examined the health records of 396,963 people from the OneFlorida+ Clinical Research Consortium between January 2014 and June 2023. All patients were aged over 50 and had type 2 diabetes. They had no diagnosis of Alzheimer's disease and related dementias (ADRD). Researchers compared those on GLP-1RAs, SGLT-2i and other, second-line glucose-lowering drugs. The analysis found that 'both GLP-1RAs and SGLT2is were statistically significantly associated with decreased risk of ADRD compared with other GLDs, and no difference was observed between both drugs'. Meanwhile, among the GLP-1RAs, 'semaglutide seems to be promising in reducing the risk of ADRD'. 'This finding is particularly intriguing given the existing research on semaglutide's neuroprotective properties,' researchers said. Dr Leah Mursaleen, head of clinical research at Alzheimer's Research UK, said: 'The results from this study support the growing evidence that GLP-1RA and SGLT-2 inhibitors medicines may reduce dementia risk. 'We don't know yet why these medicines may be offering a protective effect, and will need more research to understand how they are affecting the brain.' She added that while the findings are 'interesting', it is important to consider if other factors might be influencing results like overall health, income or education. Meanwhile, researchers in Ireland suggested GLP-1RAs are 'associated with a statistically significant reduction in dementia'. The study analysed 26 clinical trials involving almost 165,000 patients to determine if drugs like SGLT2is and GLP-1RAs, as well as diabetes medications metformin and pioglitazone, led to a reduction in risk of dementia or cognitive impairment. It found most drugs 'were not associated with an overall reduction in all-cause dementia' although 'GLP-1RAs was associated with a statistically significant reduction in all-cause dementia'. Both studies have been published in the journal Jama Neurology. Prof Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh, group leader in the UK Dementia Research Institute, and president of the British Neuroscience Association, said the data is 'encouraging' for the 'potential of using GLP-1Ras to lower dementia risk in people with diabetes' 'But even within these two strong studies, there are slightly conflicting results over SGLT2is highlighting the need for further research,' she added. 'It is important to note that these drugs do have side effects and that they are not guaranteed to prevent dementia. 'The studies had important limitations including a relatively short follow up time. Future work will be important to understand how risk factors like diabetes and obesity increase risk of dementia to develop effective treatments and prevention strategies.' Masud Husain, a professor of neurology and cognitive neuroscience at the University of Oxford, added: 'For me, these new retrospective analyses suggest that GLP-1 receptor agonists, particularly semaglutide, might reduce the risk of developing dementia in people with type 2 diabetes. 'But we need data from prospective trials to provide stronger evidence. 'The wider question of whether such drugs might also be protective against dementia in people who don't have diabetes is a really intriguing one, and the focus of several ongoing clinical trials.'
