UK: A recent study in the journal Diabetes, Obesity and Metabolism has found that cotadutide is an effective treatment option in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). The treatment was shown to significantly improve postprandial blood sugar control and reduce bodyweight versus placebo.
"Reductions in urinary albumin-to-creatinine ratios suggest potential benefits of cotadutide on kidney function. further evaluation in larger, longer-term clinical trials may be warranted," Victoria E. R. Parker, AstraZeneca, Cambridge, UK, and colleagues wrote in their study.

Cotadutide (MEDI0382) is a balanced GLP-1 and glucagon receptor dual agonist, with an approx ratio of 5:1 GLP-1 to glucagon activity. Dr. Parker and colleagues conducted the study with an objective to assess the safety, efficacy and tolerability of cotadutide in patients with type 2 diabetes mellitus and chronic kidney disease in a phase 2a study.
The study included patients with body mass index 25-45 kg/m2, estimated glomerular filtration rate 30-59 ml/min/1.73 m2 and type 2 diabetes [glycated haemoglobin 6.5-10.5% (48-91 mmol/mol)] controlled with insulin and/or oral therapy combination. They were randomized in the ratio of 1:1 to once-daily subcutaneous cotadutide (50-300 μg) or placebo for 32 days. Plasma glucose concentration assessed using a mixed-meal tolerance test was the primary endpoint.
Salient findings of the study include:
Participants receiving cotadutide (n = 21) had significant reductions in the mixed-meal tolerance test area under the glucose concentration-time curve (–26.71% vs. +3.68%), more time in target glucose range on continuous glucose monitoring (+14.79% vs. –21.23%) and significant reductions in absolute bodyweight (–3.41 kg vs. –0.13 kg) versus placebo (n = 20).
In patients with baseline micro- or macroalbuminuria (n = 18), urinary albumin-to-creatinine ratios decreased by 51% at day 32 with cotadutide versus placebo.
No statistically significant difference was observed in mean change in estimated glomerular filtration rate between treatments.
Mild/moderate adverse events occurred in 71.4% of participants receiving cotadutide and 35.0% receiving placebo.
Cotadutide improved glycaemic control and weight loss in patients with type 2 diabetes and CKD, and also shows the potential to reduce albuminuria.
"Based on the growing evidence of the shared pathogenetic mechanisms underlying type 2 diabetes, NAFLD/non-alcoholic steatohepatitis and CKD, and the improved glycaemic control, enhanced insulin sensitivity, reduction in bodyweight and improved lipid and hepatic biomarkers in obese patients with type 2 diabetes, cotadutide may be a potentially beneficial therapy in patients with CKD and type 2 diabetes," wrote the authors.
Reference:
The study titled, "Efficacy and safety of cotadutide, a dual glucagon-like peptide-1 and glucagon receptor agonist, in a randomized phase 2a study of patients with type 2 diabetes and chronic kidney disease," was published in the journal Diabetes, Obesity and Metabolism.
DOI: https://doi.org/10.1111/dom.14712