Kristensen SL, Rørth R, Jhund PS et al (2019) 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 7: 776–85
- GLP-1 receptor agonists have been shown to reduce HbA1c as well as modestly improving lipid levels, body weight and blood pressure in people with type 2 diabetes.
- Investigators performed a systematic review and meta-analysis of large randomised controlled cardiovascular outcomes trials to establish the effects of GLP-1 receptor agonists on cardiovascular, kidney and safety outcomes in patients with type 2 diabetes.
- Seven trials (ELIXA, LEADER, SUSTAIN-6, EXSCEL, Harmony Outcomes, REWIND and PIONEER 6) including over 56,000 participants were included in the meta-analysis. The trials studied six different GLP-1 receptor agonists.
- There was a significant 12% reduction in major adverse cardiovascular events associated with the use of GLP-1 receptor agonists. Breaking this down into separate cardiovascular outcomes, a 9% drop in fatal and non-fatal myocardial infarction, 16% reduction in fatal and non-fatal stroke, and 12% fewer deaths from cardiovascular causes occurred with GLP-1 receptor agonist treatment. This class of drugs had a similar effect on cardiovascular outcomes in all patient subgroups analysed.
- GLP-1 receptor agonists significantly reduced all-cause mortality, hospital admission for heart failure and renal outcomes.
- The investigators concluded that GLP-1 receptor agonists improved cardiovascular and renal outcomes and reduced the risk of mortality in people with type 2 diabetes.
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024