Dulaglutide and cardiovascular outcomes in patients with type 2 diabetes: REWIND study

Česká verzia

Authors: Ivan Tkáč
Authors place of work: IV. interná klinika UPJŠ LF a UNLP Košice
Published in the journal: Forum Diab 2019; 8(3): 208-211
Category:

Summary

In the REWIND study, the effect of GLP1 receptor agonist (GLP1RA) dulaglutide vs. placebo on prevention of cardiovascular event was compared as an add-on therapy in patients with type 2 diabetes. This study included the lowest risk population of patients with type 2 diabetes among the studies with GLP1RA so far, since only 31% of the enrolled patients had had previous cardiovascular disease. Dulaglutide given once weekly significantly reduced the incidence of the primary outcome – major cardiovascular events by 12%, and of stroke by 24%. The composite renal outcome reflecting the progression of chronic kidney disease was also significantly reduced by 15%. Thus, in the REWIND study, the previous positive results of GLP1RA studies were replicated in a significantly less at-risk population, since in the previous studies the proportion of patients with previous cardiovascular disease was greater than 75%. Due to their anti-atherogenic effect, treatment with GLP1RA is indicated not only in diabetics with previous cardiovascular diseases but also in diabetics at very high or high cardiovascular risk.

Keywords:

cardiovascular disease – dulaglutide – GLP1 receptor agonists – type 2 diabetes

Zdroje

Marso SP, Daniels GH, Brown-Frandsen K et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375(4): 311–322. Dostupné z DOI: <http://doi: 10.1056/NEJMoa1603827>.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375(19): 1834–1844.
Hernandez AF, Green JB, Janmohamed S et al. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular diesease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. Lancet 2018; 392(10157): 1519–1529. Dostupné z DOI: <http://doi: 10.1016/S0140–6736(18)32261-X>.
Gerstein HC, Calhoun HM, Dagenais GR et al. 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://doi: 10.1016/S0140–6736(19)31149–3>.
Gerstein HC, Calhoun HM, Dagenais GR, et al. Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Lancet 2019; 394(10193): 131–138. Dostupné z DOI: <http://doi: 10.1016/S0140–6736(19)31150-X>.
Pfeffer MA, Claggett B, Diaz R et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med 2015; 373(23): 2247–2257. Dostupné z DOI: <http://doi: 10.1056/NEJMoa1509225>.
Holman RR, Bethel MB, Mentz RJ et al. 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://doi: 10.1056/NEJMoa1612917>.
Drucker DJ. The ascending GLP-1 road from clinical safety to reduction of cardiovascular complications. Diabetes 2018; 67(9): 1710–1719. Dostupné z DOI: <http://doi: 10.2337/dbi18–0008>.
Cosentino F, Grant PJ, Aboyans V et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2019. Dostupné z DOI: <http://doi: 10.1093/eurheartj/ehz486>. [Epub ahead of print].