Efficacy and Cardiovascular Safety of GLP-1 Receptor Analogues

Author(s): Anoop Mohamed Iqbal, Nasvin Imamudeen, Amjad Basheer, Sukrita Menon, Gisha Mohan, Tesil Nedumkallel Sani, Nisha Nigil Haroon*

Journal Name: Current Drug Safety

Volume 16 , Issue 2 , 2021


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Abstract:

Glucagon-like peptide- 1 receptor analogs (GLP-1RAs) are incretin mimetics with potent glucose-dependent insulinotropic action that translates to glycemic control in people with type- -2 diabetes mellitus (T2DM). These agents potentially have the ability to stimulate proliferation or prevent apoptosis of pancreatic β-cells, induce weight-loss and provide vascular benefits in patients with T2DM. Newer GLP-1RA, semaglutide has shown a robust reduction in HbA1c up to 1.5 - 1.8%. However, individual differences exist between the different GLP-1RAs, in terms of efficacy, pharmacokinetics, tolerability, and vascular protection. The potential of vascular protection offered by newer anti-diabetic agents has generated a lot of excitement in the field of diabetes, and to a large extent, is now driving treatment decisions. So far, six cardiovascular outcome trials of GLP-1 RAs have been published, analyzing lixisenatide (ELIXA), liraglutide (LEADER), semaglutide (SUSTAIN-6), long-acting exenatide (EXSCEL), dulaglutide (REWIND), and oral semaglutide (PIONEER 6) with a follow-up duration of 2-4 years. LEADER, REWIND and SUSTAIN-6 trials have demonstrated a reduction in rates of major adverse cardiovascular events with active GLP-1 RA treatment, but ELIXA, PIONEER 6 and EXSCEL, have been neutral. In this review, we discuss the available evidence from randomized controlled trials (RCTs) analyzing the cardiovascular effects of various GLP-1 RAs with the aim of comparing individual drugs. We have also summarized the general aspects of GLP-1RAs that can be applied in clinical practice.

Keywords: Diabetes mellitus, cardiovascular disease, cardiovascular outcome trials (CVOTs), glucagon-Like peptide 1, weight- loss.

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Article Details

VOLUME: 16
ISSUE: 2
Year: 2021
Page: [197 - 206]
Pages: 10
DOI: 10.2174/1574886315999201208212356
Price: $95

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