MONDAY, Aug. 12, 2024 (HealthDay News) — Treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is associated with lower rates of hyperkalemia and a lower rate of discontinuation of renin-angiotensin system inhibitors (RASi) compared with treatment with dipeptidyl peptidase-4 inhibitors (DPP-4is) in patients with type 2 diabetes (T2D), according to a study published online Aug. 12 in JAMA Internal Medicine.

Tao Huang of Peking University in Beijing and colleagues compared hyperkalemia and RASi persistence rates in new users of GLP-1 RAs with users of DPP-4is in a cohort study of adults with type 2 diabetes who started GLP-1 RA or DPP-4i treatment between January 1, 2008, and December 31, 2021. Data from 33,280 people were included: 13,633 used GLP-1 RAs and 19,647 used DPP-4is.

The median duration of treatment was 3.9 months. The researchers found that the use of GLP-1 RA was associated with a lower rate of hyperkalemia and moderate to severe hyperkalemia compared with the use of DPP-4i (hazard ratio 0.61 and 0.52, respectively). Overall, 1,381 of the 21,751 participants who used RASis discontinued this therapy. The use of GLP-1 RA was associated with a lower rate of RASi discontinuation compared with the use of DPP-4i (hazard ratio 0.89). In intention-to-treat analyses and across different strata for age, sex, cardiovascular comorbidity, and renal function values, the results were consistent.

“Treatment with GLP-1 RAs may enable wider use of guideline-recommended cardioprotective and renal protective medications and contribute to improving clinical outcomes in this population,” the authors write.

One author revealed connections to the pharmaceutical industry.

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