Evidence map›Paper›PMID 30995972›Full record

Trial reportLancet (London, England)2019

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial.

Hiddo J L Heerspink, Hans-Henrik Parving, Dennis L Andress, George Bakris, Ricardo Correa-Rotter, Fan-Fan Hou, Dalane W Kitzman, Donald Kohan, Hirofumi Makino, John J V McMurray and 9 more

Erratum issuedAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 344 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
344citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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

344 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  7. A systematic review and meta-analysis of the effect of intravitreal VEGF inhibitors on cardiorenal outcomes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
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  20. GLP-1 receptor agonists-a potential therapy for chronic kidney disease?Clinical science (London, England : 1979) · 2026
    Review

284 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Hiddo J L HeerspinkDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. Electronic address: h.j.lambers.heerspink@umcg.nl.
Hans-Henrik ParvingDepartment of Medical Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Faculty of Health Science, Aarhus University, Aarhus, Denmark.
Dennis L AndressPharmaceutical Development, AbbVie, North Chicago, IL, USA.
George BakrisAmerican Society of Hypertension Comprehensive Hypertension Center, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA.
Ricardo Correa-RotterNational Medical Science and Nutrition Institute Salvador Zubirán, Mexico City, Mexico.
Fan-Fan HouDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, Guangzhou, China.
Dalane W KitzmanWake Forest School of Medicine, Winston-Salem, NC, USA.
Donald KohanDivision of Nephrology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Hirofumi MakinoOkayama University, Okayama, Japan.
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Joel Z MelnickPharmaceutical Development, AbbVie, North Chicago, IL, USA.
Michael G MillerPharmaceutical Development, AbbVie, North Chicago, IL, USA.
Pablo E PergolaRenal Associates PA, San Antonio, TX, USA.
Vlado PerkovicGeorge Institute for Global Health and University of New South Wales, Sydney, NSW, Australia.
Sheldon TobeDivision of Nephrology, Sunnybrook Health Sciences Centre, University of Toronto and the Northern Ontario School of Medicine, Toronto, ON, Canada.
Tingting YiPharmaceutical Development, AbbVie, North Chicago, IL, USA.
Melissa WigdersonPharmaceutical Development, AbbVie, North Chicago, IL, USA.
Dick de ZeeuwDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
SONAR Committees and Investigators

Funding

Endothelial Cell Mineralocorticoid Receptor and Tubulointerstitial FibrosisI01BX003391 · VA · HARRY S. TRUMAN MEMORIAL VA HOSPITAL · PI WHALEY CONNELL, ADAM T · 2017 to 2020
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BLRD VA I01 BX003391
6 · The paper itself

Abstract

backgroundShort-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes.

methodsWe did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18-85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR) 25-75 mL/min per 1·73 m

findingsBetween May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325) or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4-2·9). 79 (6·0%) of 1325 patients in the atrasentan group and 105 (7·9%) of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR] 0·65 [95% CI 0·49-0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%) of 1325 patients in the atrasentan group and 34 (2·6%) of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85-2·07]; p=0·208). 58 (4·4%) patients in the atrasentan group and 52 (3·9%) in the placebo group died (HR 1·09 [95% CI 0·75-1·59]; p=0·65).

interpretationAtrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease.

fundingAbbVie.

Indexed as

Administration, OralAdultAgedAged, 80 and overAtrasentanCreatinineDiabetes Mellitus, Type 2Diabetic NephropathiesDouble-Blind MethodEndothelin A Receptor AntagonistsFemaleGlomerular Filtration RateHumansMaleMiddle AgedRenal Insufficiency, ChronicAtrasentanCreatinineEndothelin A Receptor AntagonistsSerum Albumin, Human

Identifiers

PMID30995972

What OpenQuestion holds

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Registered trials

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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 OpenQuestion graph.