Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Review of Cardiovascular Outcome Trials

Publication date: Available online 23 August 2019Source: Canadian Journal of DiabetesAuthor(s): Elodie M. Varin, Brent A. McLean, Julie A. LovshinAbstractPeople with type 2 diabetes (T2D) are at heightened risk for developing cardiovascular (CV) events, and cardiovascular disease (CVD) is the leading cause of premature death amongst adults with T2D. Unfortunately, historically, some anti-diabetes agents were implicated in worsening cardiovascular function, despite improving glycemic and metabolic control. Accordingly, over a decade ago, health regulatory bodies modified approval requirements for novel anti-diabetes pharmacotherapies, requiring prospective evaluation of cardiovascular safety through long-term cardiovascular outcome trials (CVOTs). To meet regulatory requirements, CVOTs were primarily designed around establishing CV safety by demonstrating non-inferiority to placebo in addition to standard of care, without significant differences in blood glucose. If appropriately designed and powered however, these CVOTs could also determine superiority, and hence cardiovascular protection. While many of these CVOTs were initiated several years ago, the recent reporting of the results for these CVOTs have been pivotal and practice-changing. Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) are one such class of anti-diabetes therapies, wherein multiple GLP-1RAs CVOTs, but interestingly, not all, have demonstrated CV benefits. In this review, we provide a comprehensi...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research