Type 2 diabetes remains an escalating world-wide problem, despite a range of treatments.
The revelation that insulin secretion is under the control of a gut hormone, glucagon-like peptide 1
(GLP-1), led to a new paradigm in the management of type 2 diabetes. Liraglutide is a long acting
GLP-1 receptor agonist used in the treatment of type 2 diabetes. The review considers the clinical trials
with liraglutide. There are many comparator trials between liraglutide and other medicines for the
treatment of type 2 diabetes, and these trials have shown that liraglutide lowers HbA1c and body
weight, and is well tolerated. A large cardiovascular safety trial with liraglutide is presently being undertaken.
After 10 years of clinical trials with liraglutide, we do not know whether liraglutide has cardiovascular
safety in subjects with type 2 diabetes and high cardiovascular risk. Although this is not a requirement for registration
by the Food and Drug Administration (FDA), in my opinion, they should reconsider this. We also do not presently
know whether liraglutide has any beneficial effects on clinical cardiovascular outcomes.
Keywords: Clinical outcomes, clinical trials, comparator trials, liraglutide, surrogate endpoints, type 2 diabetes.
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