Abstract 12095: Efficacy, Safety, and Cardio-Protective Effect of GLP-1 Receptor Agonists Among Patients With Diabetes Mellitus: A Meta-Analysis and Meta-Regression

Abstract

Introduction: Glucagon-like peptide-1 (GLP-1) receptor agonists have shown promising results in reducing the incidence of major adverse cardiovascular events (MACE) in patients with Diabetes Mellitus (DM). However, the reports of previous trials show inconsistent reports for other endpoints like myocardial infarction, stroke, and cancer. Objective: We sought to evaluate the efficacy and safety of GLP-1 receptor agonists among DM patients by including recently published trials evaluating cardiovascular outcomes. Methods: We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until 10th March 2022. Primary clinical outcomes were the incidence of MACE. The secondary efficacy outcomes were cardiovascular mortality (CVM), all-cause mortality (ACM), myocardial infarction (MI), stroke, and heart failure hospitalization (HFH). Results: A total of 8 randomized controlled trials with xx (518,105 GLP-1 RA vs. 6,817,729 placebo) patients were included in the analysis. The mean age of the patients with GLP-1 RA and the placebo group was 70.0 and 69.2 years. The mean follow-up duration was xx years. Pooled analysis shows that GLP-1 receptor agonists were associated with significant 14% reduction in MACE [HR 0.86, 95% CI (0.80-0.93), p<0.01], 17% reduction in stroke [HR 0.83, 95% CI (0.76-0.92), p<0.01], 10% reduction in MI [HR 0.90, 95% CI (0.83-0.99), p=0.02], 13% reduction in CVM [HR 0.87, 95% CI (0.81-0.94), p<0.01), 12% reduction in ACM [HR 0.88, 95% CI (0.83-0.93), p<0.01] and 9% reduction in HFH [HR 0.91, 95% CI (0.84-0.99), p=0.04] compared to that of placebo. Among safety outcomes, the risk of thyroid cancer was significantly higher in GLP-1 RA [OR 2.33, 95% CI (1.08-5.03), p=0.03) compared to placebo. Conclusions: GLP-1 receptor agonists significantly reduced MACE, MI, ACM, CVM, HFH, and stroke. However, the risk of thyroid cancer significantly increased in GLP-1 RA patients.