Cardioprotective effect of treatment by GLP-1 analogues in the view of results of newest clinical studies
Authors:
Marián Mokáň; Peter Galajda
Authors‘ workplace:
I. interná klinika JLF UK a UNM, Martin
Published in:
Forum Diab 2021; 10(2): 108-113
Category:
Overview
Glucagon like peptide-1 receptor agonists are modern group of antidiabetic treatment in type 2 diabetes mellitus patients with documented good effect and safety. They are better effective on glycaemic parameters compared to other antidiabetic drugs with low risk of hypoglycaemia. They significantly decrease body weight and they have documented cardiovascular benefit, nephroprotectivity and protective effect on B-cells function. These drugs are recommended preferred treatment in diabetic patients with high cardiovascular risk or pre-existing atherosclerotic cardiovascular disease. On the market there are available drugs applied once weekly. Long acting semaglutide meets criteria of effectivity and safety as well as cardiovascular protectivity.
Keywords:
cardiovascular benefit – glucagon like peptide 1 receptor agonists – semaglutide – type 2 diabetes mellitus
Sources
1. Martinka E, Tkáč I, Mokáň M et al. Interdisciplinárne štandardy diagnostiky a liečby diabetes mellitus, jeho komplikácií a najvýznamnejších sprievodných ochorení. Forum Diab 2018; 7(Suppl 1): 5–153.
2. [American Diabetes Association]. Cardiovascular disease and risk management: standards of Medical Care in Diabetes – 2021. Diabetes Care 2021; 44(Suppl 1): S125-S150. Dostupné z DOI: <http://dx.doi.org/10.2337/dc21-S010>.
3. Sorli C, Harashima SI, Tsokas GM et al. Efficacy and safety of once- weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol 2017; 5(4): 251–260. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30013-X>.
4. Ahren B, Masmiquel L, Kumar H et al. Efficacy and safety of once- weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56-week, double-blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol 2017; 5(5): 341–354. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30092-X>.
5. Ahmann AJ, Capehorn M, Charpentier G et al. Efficacy and safety of once-weekly semaglutide versus exenatide ER in subjects with type 2 diabetes (SUSTAIN 3): A 56-week, open-label, randomized clinical trial. Diabetes Care 2018; 41(2): 258–266. Dostupné z DOI: <http://dx.doi.org/10.2337/dc17–0417>.
6. Aroda VR, Bain SC, Cariou B et al. Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial. Lancet Diabetes Endocrinol 2017; 5(5): 355–366. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30085–2>.
7. Rodbard HW, Lingvay I, Reed J et al. Semaglutide added to basal insulin in type 2 diabetes (SUSTAIN 5): A randomized, controlled trial. J Clin Endocrinol Metab 2018; 103(6): 2291–2301. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2018–00070>.
8. Marso SP, Bain SC, Consoli A et al. SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375(19): 1834–1844. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1607141>.
9. Pratley RE, Aroda VR, Lingvay I et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol 2018; 6(4): 275–228. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(18)30024-X>.
10. Lingvay I, Catarig AM, Frias JP et al. Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): a double-blind, phase 3b, randomised controlled trial. Lancet Diabetes Endocrinol 2019; 7(11): 834–844. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(19)30311–0>.
11. Zinman B, Bhosekar V, Busch R et al. Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2019; 7(5): 356–367. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(19)30066-X>.
12. Capehorn MS, Catarig AM, Furberg JK et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab 2020; 46(2): 100–109. Dostupné z DOI: <http://dx.doi.org/10.1016/j.diabet.2019.101117>.
13. Douros A, Filion KB, Yin H et al. Glucagon-like peptide-1 receptor agonists and the risk of incident diabetic retinopathy. Diabetes Care 2018; 41(11): 2330–2338. Dostupné z DOI: <http://dx.doi.org/10.2337/dc17–2280>.
14. Gaborit B, Julla JB, Besbes S et al. Glucagon-like peptide 1 receptor agonists, diabetic retinopathy and angiogenesis: The AngioSafe Type 2 Diabetes Study. J Clin Endocrinol Metab 2020; 105(4): e1549–e1560. Dostupné z DOI: <http://dx.doi.org/10.1210/clinem/dgz069>.
15. Pfeffer MA, Claggett B, Diaz R et al. [ELIXA Investigators]. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med 2015; 373(23): 2247–2257. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1509225>.
16. Marso SP, Daniels GH, Brown-Frandsen K et al. [LEADER Steering Committee. LEADER Trial Investigators]. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375(4): 311–322. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1603827>.
17. Husain M, Birkenfeld AL, Donsmark M et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2019; 381(9): 841–851. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1901118>.
18. Holman RR, Bethel MA, Mentz RJ et al. EXSCEL Study Group. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2017; 377(13): 1228–1239. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1612917>.
19. Gerstein HC, Colhoun HM, Dagenais GR et al. [REWIND Investigators]. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019; 394(10193): 121–130. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(19)31149–3.
20. Hernandez AF, Green JB, Janmohamed S et al. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. Lancet 2018; 392(10157): 1519–1529. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(18)32261-X>.
21. Tkáč I. Výsledky štúdie EXSCEL v kontexte predchádzajúcich štúdií s agonistami GLP-1 receptorov. Interná Med 2017; 17(11): 429–432.
22. Sposito AC, Berwanger O, de Carvalho LSF et al. GLP-1RAs in type 2 diabetes: Mechanisms that underlie cardiovascular effects and overview of cardiovascular outcome data. Cardiovasc Diabetol 2018; 17(1): 157. Dostupné z DOI: <http://dx.doi.org/10.1186/s12933–018–0800–2>.
23. Del Olmo-Garcia MI, Merino-Torres JF. GLP-1 receptor agonists and cardiovascular disease in patients with type 2 diabetes. J Dia betes Res 2018; 2018: 4020492. Dostupné z DOI: <http://dx.doi.org/10.1155/2018/4020492>.
24. Iorag AR, Balabasa N, Carsote M et al. Metabolic and cardiovascular benefits of GLP-1 agonists, besides the hypoglycemic effect. Exp Ther Med 2020; 20(3): 2396–2400. Dostupné z DOI: <http://dx.doi.org/10.3892/etm.2020.8714>.
25. Lee YS, Park MS, Choung JS et al. Glucagon-like peptide-1 inhibits adipose tissue macrophage infiltration and inflammation in an obese mouse model of diabetes. Diabetologia 2012; 55(9): 2456–2468. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–012–2592–3>.
26. Vinué Á, Navarro J, Herrero-Cervera A et al. The GLP-1 analogue lixisenatide decreases atherosclerosis in insulin-resistant mice by modulating macrophage phenotype. Diabetologia 2017; 60(9): 1801– 1812. <http://dx.doi.org/10.1007/s00125–017–4330–3>.
27. Wan S, Sun H. Glucagon-like peptide-1 modulates RAW264.7 macrophage polarization by interfering with the JNK/ STAT3 signaling pathway. Exp Ther Med 2019; 17(5): 3573–3579. Dostupné z DOI: <http://dx.doi.org/10.3892/etm.2019.7347>.
28. Hadjiyanni I, Siminovitch KA, Danska JS et al. Glucagon-like peptide- 1 receptor signalling selectively regulates murine lymphocyte proliferation and maintenance of peripheral regulatory T cells. Diabetologia 2010; 53(4): 730–740. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–009–1643-x>.
29. Sharma A, Ambrosy AP, DeVore AD et al. Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: Insights from the FIGHT trial. ESC Heart Fail. 2018; 5(6): 1035–1043. Dostupné z DOI: <http://dx.doi.org/10.1002/ehf2.12334>.
30. Kushner RF, Calanna S, Davies M et al. Semaglutide 2.4 mg for the treatment of obesity: Key elements of the STEP trials 1 to 5. Obesity (Silver Spring) 2020; 28(6): 1050–1061. Dostupné z DOI: <http://dx.doi.org/10.1002/oby.22794>.
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Diabetology Endocrinology Internal medicineArticle was published in
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