A recent study found that long-term intrafemoral artery infusion of low-dose urokinase therapy improved diabetic foot ulcer (DFU) and decreased cardiovascular events in patients with DFUs. This study was published in the journal, BMJ Open Diabetes Research & Care.

This single-center, randomized, parallel study included 195 patients with DFU who were randomized either to continuous intrafemoral thrombolysis or conventional therapy groups. The first group received continuous intrafemoral urokinase injection for 7 days while the latter just received wound debridement and dressing change as part of the conventional group.  Subsequently, a follow-up of an average duration of 6.5 years was performed.

At the first month of intervention stage, it was found that in comparison with the conventional group, the ulcers achieved a significant improvement in continuous intrafemoral thrombolysis group which included an improved ulcer (27.6% vs 25.8%), a complete closure (72.4% vs 17.5%), and unchanged or impaired ulcer (0% vs 56.7%). Also, during the 6.5-year follow-up, the interventional group obtained a better complete healing rate for the primary outcome of ulcer closure rate. The secondary outcome of cardiovascular disease events showed a lower incidence with the continuous intrafemoral thrombolysis therapy, along with decreased incidence of cardiovascular death. Other than this, the therapy also improved local skin oxygenation and peripheral neuropathy as well as glycolipid metabolic profiles compared with the conventional therapy group.

From the above results, it can be concluded that better therapeutic efficacy to improve DFUs and decrease cardiovascular events may be possible with continuous intrafemoral thrombolysis therapy.

A recent study suggests that tirzepatide therapy demonstrated a decrease in the predicted 10-year risk of developing type 2 diabetes (T2D) when compared to placebo among individuals, who were either obese or overweight. The study’s findings were published in the journal, Diabetes, obesity & metabolism.

In the post hoc analysis study of SURMOUNT-1, the Cardiometabolic Disease Staging risk engine was utilized to calculate the predicted  10-year risk of T2D at baseline, week 24, and week 72 among participants who were randomized to receive either 5, 10, or 15 mg tirzepatide or placebo. The mean changes in risk scores from baseline to weeks 24 and 72 were compared between the tirzepatide and placebo groups. The participants' glycaemic status and body mass index at baseline were used to conduct subgroup analyses.

At week 72, the tirzepatide groups demonstrated significantly higher reductions in mean absolute T2D predicted risk scores : 5 mg (12.4%), 10 mg (14.4%), and 15 mg (14.7%) when compared to the placebo group (0.7%). Participants with and without prediabetes experienced significantly greater risk reductions in the tirzepatide groups compared to the placebo group. Participants with prediabetes (range: 16.0%- 20.3%) had greater mean risk score reductions from baseline compared to those without prediabetes (range: 10.1% -11.3%). Additionally, across different body mass index subgroups, the tirzepatide groups exhibited significantly higher mean reductions from baseline compared to the placebo group.

To summarize, tirzepatide demonstrated a substantial decrease in the predicted 10-year risk of developing type 2 diabetes (T2D) when compared to a placebo in individuals with obesity or overweight, irrespective of their baseline glycemic status.

A recent study found that endothelin receptor antagonist atrasentan reduced pain-related events and use of analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in selected patients with type 2 diabetes and chronic kidney disease (CKD). The study’s findings were published in the journal Kidney international.

SONAR trial was a randomized, double-blind, placebo-controlled study that included participants with type 2 diabetes and CKD. They were randomized to receive either atrasentan or placebo (n=1834 in each arm). The main outcome of the study was pain-related adverse events (AEs). Cox regression was used to analyze the effect of atrasentan on the risk of the first pain-related AE and the first prescription of analgesics in comparison with the placebo. Also, the Anderson-Gill method was used to assess effects on all pain-related AEs.

It was found that during the 2.2-year median follow-up, there were 1183 pain-related AEs. The first pain-related event rates in the atrasentan and placebo groups were 138.2 and 170.2 per 1000 person-years, respectively. Also, with atrasentan all pain-related AEs were reduced. Additionally, patients treated with atrasentan initiated fewer analgesics compared to the placebo.

From the above results, it can be concluded that atrasentan may be associated with reduced pain-related events and use of analgesics in carefully selected patients having type 2 diabetes and CKD.