PMID- 32740122
OWN - NLM
STAT- MEDLINE
DCOM- 20210210
LR  - 20210211
IS  - 1547-1896 (Print)
IS  - 0893-7400 (Linking)
VI  - 33
IP  - 8
DP  - 2020 Aug
TI  - Long-acting GLP-1 receptor agonists: Findings and implications of cardiovascular 
      outcomes trials.
PG  - 19-30
LID - 10.1097/01.JAA.0000669452.63883.45 [doi]
AB  - Cardiovascular disease (CVD) is a common and serious comorbidity of type 2 
      diabetes mellitus (T2DM), and cardiovascular (CV) risk assessment has become an 
      important aspect of evaluating new therapies for T2DM before approval by the FDA. 
      Since 2008, in order to establish safety, new therapies for T2DM have been 
      required to demonstrate that they will not result in an unacceptable increase in 
      CV risk. Studies performed for this purpose are termed CV outcome trials, or 
      CVOTs. This article reviews CVOTs completed to date for the class of long-acting 
      glucagon-like peptide-1 receptor agonists (GLP-1RAs; liraglutide, exenatide 
      extended-release, albiglutide, dulaglutide, semaglutide injectable, semaglutide 
      oral) and implications for clinical management of T2DM. All CVOTs have confirmed 
      long-acting GLP-1RAs to be noninferior to (not worse than) placebo with regard to 
      first occurrence of a primary outcome of three-point major adverse cardiovascular 
      events (MACE; composite outcome of cardiovascular death, nonfatal myocardial 
      infarction, nonfatal stroke). Further, a number of the studies demonstrated a 
      statistically significant reduction in primary outcomes of three-point MACE with 
      GLP-1RA treatment compared with placebo. As a result, the product labeling for 
      liraglutide, semaglutide injectable, and dulaglutide has been updated with an 
      indication for reducing the risk of MACE in adults with T2DM and established CVD 
      (all) or multiple CV risk factors (dulaglutide only). These findings have brought 
      about an exciting paradigm shift from concern about not inflicting CV harm to the 
      exciting prospect of reducing risks of CV outcomes. Major diabetes care 
      guidelines now encourage early consideration of GLP-1RA use in patients with 
      atherosclerotic CVD.
FAU - Urquhart, Scott
AU  - Urquhart S
AD  - Scott Urquhart practices at Diabetes and Thyroid Associates in Fredericksburg, 
      Va., is chair of the Metabolic and Endocrine Disease Summit, an adjunct clinical 
      professor in the PA program at James Madison University in Harrisonburg, Va., and 
      a clinical instructor in the PA program at George Washington University in 
      Washington, D.C. Stephen Willis practices at the Multicare-Rockwood Clinic in 
      Spokane, Wash., and is department chair of the Endocrinology and Advanced 
      Diabetes Center. Mr. Urquhart discloses that he has served on advisory boards for 
      Astra Zeneca, Dexcom, and Sanofi; on speakers' bureaus for Astra Zeneca, Dexcom, 
      and Novo Nordisk Inc; and as a consultant for Novo Nordisk Inc. Stephen Willis 
      has served on an advisory board for Eli Lilly. This manuscript was funded by Novo 
      Nordisk Inc. The authors have disclosed no other potential conflicts of interest, 
      financial or otherwise.
FAU - Willis, Stephen
AU  - Willis S
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - JAAPA
JT  - JAAPA : official journal of the American Academy of Physician Assistants
JID - 9513102
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Immunoglobulin Fc Fragments)
RN  - 0 (Recombinant Fusion Proteins)
RN  - 53AXN4NNHX (semaglutide)
RN  - 5E7U48495E (rGLP-1 protein)
RN  - 62340-29-8 (Glucagon-Like Peptides)
RN  - 839I73S42A (Liraglutide)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
RN  - 9P1872D4OL (Exenatide)
RN  - WTT295HSY5 (dulaglutide)
MH  - Administration, Oral
MH  - Cardiovascular Diseases/*etiology/*prevention & control
MH  - Delayed-Action Preparations
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Exenatide/administration & dosage
MH  - Glucagon-Like Peptide 1/administration & dosage/analogs & derivatives
MH  - Glucagon-Like Peptide-1 Receptor/*agonists
MH  - Glucagon-Like Peptides/administration & dosage/*analogs & derivatives
MH  - Heart Disease Risk Factors
MH  - Humans
MH  - Immunoglobulin Fc Fragments/*administration & dosage
MH  - Injections
MH  - Liraglutide/*administration & dosage
MH  - Practice Guidelines as Topic
MH  - Recombinant Fusion Proteins/*administration & dosage
MH  - Treatment Outcome
MH  - United States
MH  - United States Food and Drug Administration
EDAT- 2020/08/03 06:00
MHDA- 2021/02/11 06:00
CRDT- 2020/08/03 06:00
PHST- 2020/08/03 06:00 [entrez]
PHST- 2020/08/03 06:00 [pubmed]
PHST- 2021/02/11 06:00 [medline]
AID - 01720610-202008000-00017 [pii]
AID - 10.1097/01.JAA.0000669452.63883.45 [doi]
PST - ppublish
SO  - JAAPA. 2020 Aug;33(8):19-30. doi: 10.1097/01.JAA.0000669452.63883.45.