Effects of glucagon-like peptide-1 receptor agonists on cardiovascular risk: a meta-analysis of randomized clinical trials

2013 ◽  
Vol 16 (1) ◽  
pp. 38-47 ◽  
Author(s):  
M. Monami ◽  
I. Dicembrini ◽  
C. Nardini ◽  
I. Fiordelli ◽  
E. Mannucci
Keyword(s):  
Clinical Trials ◽  
Cardiovascular Risk ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Glucagon-like peptide-1 receptor agonists and pancreatitis: A meta-analysis of randomized clinical trials

2014 ◽  
Vol 103 (2) ◽  
pp. 269-275 ◽  
Author(s):  
Matteo Monami ◽  
Ilaria Dicembrini ◽  
Camilla Nardini ◽  
Irene Fiordelli ◽  
Edoardo Mannucci
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

scholarly journals Effects of Glucagon-Like Peptide-1 Receptor Agonists on Body Weight: A Meta-Analysis

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Matteo Monami ◽  
Ilaria Dicembrini ◽  
Niccolò Marchionni ◽  
Carlo M. Rotella ◽  
Edoardo Mannucci
Keyword(s):  
Body Weight ◽  
Weight Reduction ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Pharmacological Interventions ◽  
Receptor Agonists ◽  
Cochrane Database ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Glucagon-Like Peptide-1 receptor agonists (GLP-1RAs), approved as glucose-lowering drugs for the treatment of type 2 diabetes, have also been shown to reduce body weight. An extensive Medline, Cochrane database, and Embase search for “exenatide,” “liraglutide,” “albiglutide,” “semaglutide,” and “lixisenatide” was performed, collecting all randomized clinical trials on humans up to December 15, 2011, with a duration of at least 24 weeks, comparing GLP-1 receptor agonists with either placebo or active drugs. Twenty two (7,859 patients) and 7 (2,416 patients) trials with available results on body weight at 6 and 12 months, respectively, were included. When compared with placebo, GLP-1RAs determine a reduction of BMI at 6 months of −1.0 [−1.3; −0.6] kg/m2. Considering the average BMI at baseline (32.4 kg/m2) these data means a weight reduction of about 3% at 6 months. This result could seem modest from a clinical standpoint; however, it could be affected by many factors contributing to an underestimation of the effect of GLP-1RA on body weight, such as non adequate doses, inclusion criteria, efficacy of GLP-1RA on reducing glycosuria, and association to non-pharmacological interventions not specifically aimed to weight reduction.

scholarly journals Glucagon-like peptide-1 receptor agonists in type 2 diabetes: a meta-analysis of randomized clinical trials

2009 ◽  
Vol 160 (6) ◽  
pp. 909-917 ◽  
Author(s):  
Matteo Monami ◽  
Niccolò Marchionni ◽  
Edoardo Mannucci
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Relevant Information ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

ObjectiveThe role of glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes is debated; many recent trials, which were not included in previous meta-analyses, could add relevant information.Design and methodsAll available randomized controlled trials (RCTs), either published or unpublished, performed in type 2 diabetic patients with GLP-1 receptor agonists (exenatide and liraglutide), with a duration>12 weeks were meta-analysed for HbA1c, body mass index, hypoglycaemia and other adverse events.Results and conclusionsA total of 21 RCTs (six of which unpublished), enrolling 5429 and 3053 patients (with GLP-1 receptor agonists and active comparator or placebo respectively), was retrieved and included in the analysis. GLP-1 receptor agonists determine a significant improvement of HbA1c in comparison with placebo (−1.0 (−1.1, −0.8),P<0.001), with a low risk of hypoglycaemia. There is no evidence of increased cardiovascular risk with the use of GLP-1 receptor agonists. GLP-1 receptor agonists, which induce weight loss, are associated with gastrointestinal side effects. GLP-1 receptor agonists are effective in reducing HbA1c and postprandial glucose. In patients failing to sulphonylureas and/or metformin, GLP-1 receptor agonists are similarly effective as insulin. Available data suggest that the efficacy and tolerability of the novel agent, liraglutide, which is adequate for once-a-day administration, are comparable with those of exenatide bis in die.

Assessment of Cardiovascular Risk With Glucagon-Like Peptide 1 Receptor Agonists in Patients With Type 2 Diabetes Using an Alternative Measure to the Hazard Ratio

2018 ◽  
Vol 52 (7) ◽  
pp. 632-638 ◽  
Author(s):  
Masayuki Kaneko ◽  
Mamoru Narukawa
Keyword(s):  
Clinical Trials ◽  
Cardiovascular Events ◽  
Randomized Clinical Trials ◽  
Alternative Measure ◽  
Cardiovascular Risks ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
The Difference

Background: Randomized clinical trials with the aim of evaluating the cardiovascular risks associated with glucagon-like peptide 1 (GLP-1) receptor agonists, lixisenatide, liraglutide, semaglutide, and exenatide, have been conducted. They showed different results among the agents, but the reason has not been explained. Objective: To evaluate the cardiovascular risks associated with GLP-1 receptor agonists by using an alternative measure to the hazard ratio. Methods: We used the difference in restricted mean survival time (RMST) as a measure of cardiovascular risks. Four randomized clinical trials with cardiovascular events as a primary endpoint, ELIXA (lixisenatide), LEADER (liraglutide), SUSTAIN-6 (semaglutide), and EXSCEL (exenatide), were reevaluated by estimating the RMSTs for each of the agents and placebo based on the reconstructed individual patient data for each time-to-event outcome from publicly available information. Results: The differences of RMSTs (GLP-1 receptor agonist minus placebo: point estimate and 95% CI) for primary composite endpoint of cardiovascular events were 0 days [−14, 14] in ELIXA (1080 days follow-up), 20 days [6, 34] in LEADER (1620 days follow-up), 8 days [1, 15] in SUSTAIN-6 (672 days follow-up), and 11 days [−3, 26] in EXSCEL (1825 days follow-up). As for the risk of other cardiovascular outcomes, there were no substantial differences between GLP-1 receptor agonists and placebo. Conclusions: Liraglutide and semaglutide decrease the risk of major adverse cardiovascular events compared with placebo when using the difference in RMST. The previously reported result that GLP-1 receptor agonists do not increase the risk of cardiovascular outcomes compared with placebo is also confirmed.

974-P: Network Meta-analysis of Once Weekly Glucagon-Like Peptide-1 Receptor Agonists: A Focus on Cardiovascular Safety and Mortality

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 974-P
Author(s):  
OSAMAH ALFAYEZ ◽  
OMAR A. ALMOHAMMED ◽  
OMAR ALKHEZI ◽  
MAJED S. AL YAMI
Keyword(s):  
Meta Analysis ◽  
Cardiovascular Safety ◽  
Receptor Agonists ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1
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