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This trial provides head-to-head data that strengthens the regulatory package and informs clinical positioning

However, in a sensitivity analysis of the REWIND study with dulaglutide, the relative risk reduction for a 40% or 50% decrease in eGFR was 30% and 44%, both significant, in the dulaglutide group compared to placebo, respectively.92 This lower risk of developing macroalbuminuria was also confirmed in an exploratory analysis of the ELIXA (lixisenatide) study.93 In the EXSCEL study (exenatide LAR), renal episodes were analyzed as additional microvascular episodes, and no differences were observed in the risk of episodes related to decreased eGFR, but differences were observed in the composite episode, which included decreased eGFR and macroalbuminuria, although only after adjustment94 (Table 2)

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