Evidence map›Paper›PMID 33908691›Full record

Trial reportDiabetes, obesity & metabolism2021

Effect of exenatide twice daily and dapagliflozin, alone and in combination, on markers of kidney function in obese patients with type 2 diabetes: A prespecified secondary analysis of a randomized controlled clinical trial.

Charlotte C van Ruiten, Annemarie B van der Aart-van der Beek, Richard G IJzerman, Max Nieuwdorp, Klaas Hoogenberg, Daniël H van Raalte, Hiddo J L Heerspink

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 4 pooled it
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 50 citations in OpenAlex.

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  15. GLP-1-based therapeutics for cardiorenal protection in metabolic diseases.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Review
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  17. Do SGLT2 Inhibitors Protect the Kidneys? An Alternative Explanation.Endocrine, metabolic & immune disorders drug targets · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Charlotte C van RuitenDiabetes Centre, Department of Internal Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands.ORCID 0000-0002-6123-5140
Annemarie B van der Aart-van der BeekClinical Pharmacy and Pharmacology, University of Groningen, Groningen, The Netherlands.ORCID 0000-0003-1473-3259
Richard G IJzermanDiabetes Centre, Department of Internal Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands.ORCID 0000-0001-7951-786X
Max NieuwdorpDiabetes Centre, Department of Internal Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands.ORCID 0000-0002-1926-7659
Klaas HoogenbergDepartment of Internal Medicine, Martini Hospital, Groningen, The Netherlands.
Daniël H van RaalteDiabetes Centre, Department of Internal Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands.ORCID 0000-0003-2894-6124
Hiddo J L HeerspinkClinical Pharmacy and Pharmacology, University of Groningen, Groningen, The Netherlands.ORCID 0000-0002-3126-3730
Amsterdam Neuroscience · NLUniversity Medical Center Groningen · NLMartini Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo evaluate the effects of separate and combined use of the sodium-glucose cotransporter-2 (SGLT2) inhibitor dapagliflozin and the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide on measures of kidney function.

methodsIn this prespecified secondary analysis of the DECREASE trial, we enrolled 66 obese patients with type 2 diabetes in a 16-week randomized double-blind placebo-controlled clinical trial to investigate the effects of dapagliflozin and exenatide twice daily, alone or in combination, versus placebo on 24-hour urinary albumin:creatinine ratio (UACR), creatinine and cystatin C-estimated glomerular filtration rate (GFR) and kidney injury molecule-1:creatinine ratio (KIM-1:Cr).

resultsAt week 16, the mean UACR change from baseline was -39.6% (95% confidence interval [CI] -58.6, -11.9; P = 0.001) in the combined exenatide-dapagliflozin group, -18.1% (95% CI -43.1, 18.0; P = 0.278) in the dapagliflozin group, -15.6% (95% CI -41.4, 21.6; P = 0.357) in the exenatide group and - 11.0% (95% CI -39.8, 31.5; P = 0.552) in the placebo group. Compared to placebo, UACR difference at week 16 in the exenatide-dapagliflozin group was -32.2% (95% CI -60.7, 16.9; P = 0.159). Effects were similar in 37 participants who were using angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at baseline. Compared to placebo, in the exenatide-dapagliflozin group, an acute dip in estimated GFR was observed with creatinine-estimated GFR (-4.0 mL/min/1.73 m

conclusionThis prespecified secondary analysis suggests that combined therapy with exenatide and dapagliflozin may have synergistic effects on markers of kidney function compared to either therapy alone or placebo in obese patients with type 2 diabetes.

Indexed as

Diabetes Mellitus, Type 2Benzhydryl CompoundsDouble-Blind MethodExenatideGlucosidesHumansKidneyObesityBenzhydryl CompoundsdapagliflozinExenatideGlucosidesdapagliflozindiabetic kidney diseaseexenatideGLP-1RAglucagon-like peptide-1 receptor agonistsSGLT2 inhibitors

Identifiers

PMID33908691
PMCPMC8360098
OpenAlexW3157362346

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.