|Title||Effect of glucagon-like peptide-1 receptor agonists on all-cause mortality and cardiovascular outcomes: A meta-analysis.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Peterson S, Barry A|
|Journal||Curr Diabetes Rev|
BACKGROUND: Cardiovascular disease is the leading cause of death in patients with type 2 diabetes.
OBJECTIVE: To assess the impact of glucagon-like peptide-1 receptor agonist (GLP1RA) therapy, compared to placebo, on clinically relevant outcomes including all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, and hospitalizations for heart failure, in patients with type 2 diabetes.
METHOD: EMBASE, MEDLINE, and CENTRAL were searched (inception to September 2016) for randomized, double-blind, placebo-controlled trials of at least one year in duration that compared any GLP1RA to placebo in patients with type 2 diabetes. Both authors independently completed the literature search, data extraction, and risk of bias assessment. For each outcome, a risk ratio (RR) and 95% confidence interval (CI) were calculated using a Mantel-Haenszel random effects model.
RESULTS: Eight trials (three albiglutide, two lixisenatide, two liraglutide, one semaglutide) consisting of 21,135 patients were included. Most patients had, or were at high risk for, cardiovascular disease. Follow-up ranged from 1-3.8 years. Trials contributing the majority of data were deemed to have a low risk of bias. The risk of all-cause mortality was lowered by 11% in patients receiving a GLP1RA (RR 0.89, 95% CI 0.81-0.99). There was no statistically significant difference between groups with respect to cardiovascular death, nonfatal MI, nonfatal stroke, or hospitalizations for heart failure.
CONCLUSION: GLP1RA therapy when compared to placebo reduced all-cause mortality in high cardiovascular risk patients with type 2 diabetes. They did not impact cardiovascular mortality, nonfatal MI, nonfatal stroke, or heart failure hospitalizations.
|Alternate Journal||Curr Diabetes Rev|