GLP-1 receptor agonists and cardiovascular outcomes: an updated synthesis

Abstract

In The Lancet Diabetes & Endocrinology, Søren Kristensen and colleagues present a new, up-to-date systematic review and meta-analysis 1 Kristensen SL Rørth R Jhund PS et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol. 2019; (published online Aug 14.)http://dx.doi.org/10.1016/S2213-8587(19)30249-9 Summary Full Text Full Text PDF PubMed Scopus (323) Google Scholar of cardiovascular outcome trials evaluating glucagon-like peptide-1 (GLP-1) receptor agonists in patients with type 2 diabetes—a timely update after the recent reporting of the primary results from the REWIND trial of dulaglutide 2 Gerstein HC Colhoun HM Dagenais GR et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019; 394: 121-130 Summary Full Text Full Text PDF PubMed Scopus (674) Google Scholar , 3 Gerstein HC Colhoun HM Dagenais GR et al. Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Lancet. 2019; 394: 131-138 Summary Full Text Full Text PDF PubMed Scopus (164) Google Scholar and the PIONEER 6 trial of oral semaglutide. 4 Husain M Birkenfeld AL Donsmark M et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2019; (published online June 11.)DOI:10.1056/NEJMoa1901118 Crossref PubMed Scopus (391) Google Scholar Incorporating these new trials means that the new meta-analysis includes data from seven trials with a total of 56 004 patients and, of those with available data for the primary outcome of major adverse cardiovascular events (MACE), includes a minority of 12 983 patients who did not have established cardiovascular disease but rather had multiple cardiovascular risk factors (thus being considered primary prevention patients) and 10 773 patients with an estimated glomerular filtration rate of less than 60 mL/min per 1·73 m2. The findings from the meta-analysis thereby contribute useful evidence concerning the cardiovascular safety and efficacy of GLP-1 receptor agonists across a range of patient populations. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trialsTreatment with GLP-1 receptor agonists has beneficial effects on cardiovascular, mortality, and kidney outcomes in patients with type 2 diabetes. Full-Text PDF