A newer class of diabetes medications, called GLP-1 receptor agonists, has been shown to reduce the chance of heart attacks, strokes and death from cardiovascular disease by 14-15%, as well as all-cause mortality by 12-13%.
This large meta-analysis study – led by the University of Glasgow and published today in the Lancet Diabetes and Endocrinology – summarises the safety and net benefits of this class of drugs, and also found that they lower risk of hospital admission for heart failure, as well as reduced important kidney outcomes.
By examining data from eight recent trials, the study found hospital admission for heart failure was reduced by 11% and important kidney outcomes were reduced by around 18-21%.
Of the antihyperglycemic drug classes used to treat diabetes, the drug class of GLP-1 receptor agonists is the only ones to show consistent benefits in cardiovascular outcomes, including stroke. However, this study analysed the most up to date evidence on cardiovascular benefits and risks in patients with type 2 diabetes.
The results also showed that the synthetically derived exendin-4 based class of GLP-1 receptor agonists are just as effective in lowering risk of important outcomes as those human-based GLP-1 receptor agonists.
In addition, the effects on cardiovascular outcomes appeared consistent across all subgroups tested; and the incidence of severe hypoglycaemia, retinopathy, pancreatitis, and pancreatic cancer did not differ between the treatment of these drugs and placebo, reassuring that this class of drugs has an excellent benefit to safety profile.
Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow’s Institute of Cardiovascular and Medical Sciences, said: “This is an important result, as previously people were wondering whether only the human-based drugs were effective. We now show this is not the case and both types are equally effective.
“The new results for prevention of heart failure and reducing risk of kidney outcomes, support that this class of drugs does benefit cardiorenal outcomes, albeit more modestly than the other newer class of diabetes drugs called SGLT2 inhibitors. That noted, clear benefits of GLP-1 receptor agonists on reducing outcomes linked to the build-up of plaque inside arteries, in particular stroke – reduced by around 17-19% — is an important result for this class of drugs.
“Overall, these results attest to the important benefits GLP-1 receptor agonists can have in preventing important outcomes in people with diabetes with or at elevated risk of cardiovascular disease.
“In addition, that they help people lose weight and reduce blood pressure are additional benefits that matter to patients. Finally, with newer GLP-1 receptor agonists coming down the line that help people achieve considerable weight loss – around 10kg or more – the potential for this class to help reduce risks of important outcomes in a wider group of patients remains possible and is currently being tested in other outcome trials.”
The study screened 98 articles and eight trials comprising 60,080.
The study, ‘Cardiovascular, mortality, and kidney outcomes with GLP-1
receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials,’ is published in Lancet Diabetes Endocrinology.