The MARLINA-T2D trial: putting the results into clinical perspective

ABSTRACT

Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2D) frequently coexist and are associated with poor clinical outcomes. Dipeptidyl peptidase-4 (DPP-4) inhibitors can be used for patients with T2D and CKD, and preclinical evidence suggests these agents may slow the progression of kidney disease in T2D. Although clinical evidence of the renal effects of DPP-4 inhibitors is limited, the recent publication of the MARLINA-T2D study provided important new data. In MARLINA-T2D, linagliptin was associated with significant improvements in glycemic control with a non-significant reduction in albuminuria and no evidence of renal adverse effects in a high-risk population of patients with T2D and early diabetic kidney disease. Although there was no conclusive evidence of renoprotective effects, previous research suggests that clinically apparent renal benefits might develop with longer term treatment. The results of ongoing trials with primary renal endpoints are awaited with interest.

KEYWORDS:

• Linagliptin
• dipeptidyl peptidase 4 inhibitors
• renal insufficiency
• albuminuria
• type 2 diabetes mellitus

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Author contributions

The author meets criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE) and was fully responsible for all content and editorial decisions, was involved at all stages of manuscript development, and approved the final version that reflects the author’s interpretations and conclusions.

Acknowledgments

Medical writing assistance, supported financially by Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI), was provided by Jennifer Garrett, MBBS of Envision Scientific Solutions during the preparation of this review. BIPI was given the opportunity to review the manuscript for factual accuracy only.

Declaration of interest

RL has acted as a promotional speaker and/or advisor for Boehringer Ingelheim, Lilly, Novo Nordisk, Astra Zeneca and Sanofi. RL received no direct compensation related to the development of the manuscript. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

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Funding

This manuscript was not funded.