The available evidence remains however insufficient to confirm whether other effects of GLP-1RAs such as direct cardioprotective actions (i.e., effects on atrial electrical remodeling, increased left ventricular ejection fraction, increased myocardial salvage, effects on cardiac oxidative metabolism) and effects on the microvascular function may mechanistically contribute to GLP-1RA-mediated protection against stroke (Cardiovascular Diabetology)
Diabetes News
Tag: GLP-1RA
LY3437943, a novel triple GIP, GLP-1, and glucagon receptor agonist in people with type 2 diabetes: a phase 1b, multicentre, double-blind, placebo-controlled, randomised, multiple-ascending dose trial
In this early phase study, LY3437943 showed an acceptable safety profile, and its pharmacokinetics suggest suitability for once-weekly dosing. This finding, together with the pharmacodynamic findings of robust reductions in glucose and bodyweight, provides support for phase 2 development (The Lancet)
Glucagon-like peptide-1 receptor agonist prescribing patterns in adolescents with type 2 diabetes
The United States Food and Drug Administration (FDA) has approved two GLP-1RAs, liraglutide 1.8 mg/d and exenatide extended-release (ER), for T2D in youth aged 10 years or older.2 However, little is known about GLP-1RA prescribing patterns in youth. The objective of this retrospective chart review was to explore GLP-1RA prescribing practices for adolescents with T2D (Diabetes, Obesity and Metabolism)
Semaglutide reduces cardiovascular events regardless of metformin use: a post hoc subgroup analysis of SUSTAIN 6 and PIONEER 6
These findings indicate that the CV outcomes for semaglutide were similar regardless of baseline metformin use, which may also apply to all GLP-1RAs (Cardiovascular Diabetology)
SGLT2i and GLP-1RA in Cardiometabolic and Renal Diseases: From Glycemic Control to Adipose Tissue Inflammation and Senescence
This review intends to expose the probable molecular mechanisms and compile evidence of the synergistic or additive anti-inflammatory effects of SGLT2i and GLP-1RA and their potential impact on the management of patients with obesity and cardiorenal compromise (Journal of Diabetes Research)
GLP-1 receptor agonists vs. SGLT-2 inhibitors: the gap seems to be leveling off
Overall, the results of CVOTs published so far seems to suggest that the gap between the cardiorenal benefits of SGLT-2 and GLP-1RA is narrowing (Cardiovascular Diabetology)
Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression
Our study suggests that pre-admission use of GLP-1RA may offer beneficial effects on Covid-19 mortality in patients with diabetes mellitus. However, more randomized clinical trials are required to confirm this conclusion (Diabetes Research and Clinical Practice)
Cardiovascular morbidity and mortality in patients with type 2 diabetes using novel antidiabetic medicines as add-on therapy: an observational real-world study
SGLT2i and GLP-1RA improved CV morbidity and mortality in patients with T2D when compared with DPP-4i as an add-on therapy (BMJ Open)
Meta-analyses of Results From Randomized Outcome Trials Comparing Cardiovascular Effects of SGLT2is and GLP-1RAs in Asian Versus White Patients With and Without Type 2 Diabetes
Compared with Whites, Asians may derive greater CV death/HHF benefit from SGLT2is in patients with HFrEF, and MACE benefit from GLP-1RAs in patients with type 2 diabetes (Diabetes Care)
Use of Metformin and Cardiovascular Effects of New Classes of Glucose-Lowering Agents: A Meta-analysis of Cardiovascular Outcome Trials in Type 2 Diabetes
As strategy-driven, head-to-head RCTs comparing SGLT-2i, GLP-1RA, or DPP-4i with metformin (and their combination with metformin) while ensuring glycemic and weight equipoise are unlikely to become available in the future, sharing and analyzing individual-level data from already conducted RCT would help to inform the evidence for the best first-line treatment(s) in subjects with type 2 diabetes and confirm or refute our finding (Diabetes Care)
Impact of a Weekly Glucagon-Like Peptide 1 Receptor Agonist, Albiglutide, on Glycemic Control and on Reducing Prandial Insulin Use in Type 2 Diabetes Inadequately Controlled on Multiple Insulin Therapy: A Randomized Trial
A once-weekly GLP-1RA was able to substitute for prandial insulin in 54% of people, substantially reducing the number of prandial insulin injections; glycemic control improved, with the added benefits of weight loss and less hypoglycemia in the GLP-1RA arm (Diabetes Care)
Efficacy of Modern Diabetes Treatments DPP-4i, SGLT-2i, and GLP-1RA in White and Asian Patients With Diabetes
The glucose-lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared with studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA (Diabetes Care)
Use of Glucagon-Like Peptide-1 Receptor Agonists in Patients With Type 2 Diabetes and Cardiovascular Disease
Findings from this review suggest that GLP-1RAs are safe, are well tolerated, and improve cardiovascular outcomes, largely independent of their antihyperglycemic properties, but they remain underused by cardiologists (JAMA Cardiology)
The Future of the GLP-1 Receptor Agonists
Overall, the findings of the PIONEER 3 trial, along with other recent studies, indicate that the introduction of semaglutide, the first oral preparation of a GLP-1RA for which the subcutaneous agent has shown positive cardiovascular benefit, should be an important addition to the growing list of pharmacologic options for type 2 diabetes (JAMA)
Cardiovascular outcome trials of glucose-lowering medications: an update
In summary, taking into account the findings from these new studies, it is suggested that a GLP-1RA should be offered to all people with CVD and type 2 diabetes, and SGLT2 inhibitors should be prescribed for those at high risk of heart failure or with progressive decline in eGFR. DPP4 inhibitors are a safe choice within the glucose-lowering stepped algorithm (Diabetologia)
Effect of adding GLP-1RA on mortality, cardiovascular events and metabolic outcomes among insulin-treated patients with Type 2 Diabetes: A Large Retrospective UK Cohort Study
Based on a large UK cohort in routine clinical practice, adding a GLP-1RA to insulin therapy is associated with a reduction in risk of composite CV events and all-cause mortality, but non-significant higher risk of hospitalisation for heart failure in overweight patients with Type 2 diabetes (American Heart Journal)
Glucagon-like peptide-1 receptor agonists compared with basal insulins for the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis
Although weight reduction is seen with all GLP-1RA’s, only the once weekly agents, exenatide LAR and dulaglutide, demonstrate significant HbA1c reductions when compared to basal insulins (Diabetes, Obesity and Metabolism)
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