Cardiovascular Risk Does Not Differ for GLP-1 Receptor Agonists
Researchers found no significant differences in instances of CVD in patients treated with GLP-1RA compared to DPP-4i in combination with metformin.
HealthDay News — There are no significant differences in occurrence of cardiovascular disease (CVD) tied to treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA) compared with dipeptidyl peptidase-4 inhibitors (DPP-4i), second generation sulfonylureas, or insulin, in combination with metformin, according to a study published online in Diabetes, Obesity and Metabolism.
Elisabetta Patorno, MD, DrPH, from Brigham and Women's Hospital in Boston, and colleagues used data from a large US commercial health plan database linked to laboratory test results to identify 3 pairwise 1:1 propensity score (PS)-matched cohorts of type 2 diabetes mellitus patients ≥18 years treated with metformin who initiated GLP-1 RA or a comparator – DPP-4i (35,534 patients), second generation sulfonylureas (28,138 patients), or insulin (47,068 patients) – between 2005 and 2013.
The researchers found that over 1 year, CVD events per 1,000 person-years were similar among PS-matched initiators of GLP-1 RA versus DPP-4i (hazard ratio [HR], 1.02; 95% confidence interval [CI], 0.84 to 1.24) and among initiators of GLP-1 RA versus sulfonylureas (HR, 0.86; 95% CI, 0.69 to 1.08). For GLP-1 RA versus insulin, results were sensitive to the adjustment for hemoglobin A1c, after which the HR was 1.01 (95% CI, 0.73 to 1.41).
"This large study, performing head-to-head comparisons of GLP-1 RA versus other antidiabetic agents in real-world patients, provides estimates of relative safety precise enough to rule out large differences in CVD risk and adds further understanding to results from recent clinical trials," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
- Patorno E, Everett BM, Goldfine AB, et al. Comparative Cardiovascular Safety of Glucabon-Like Peptide-1 Receptor Agonists verus Other Antidiabetic Drugs in Routine Care: a Cohort Study. Diabetes Obes Metab. 2016; doi: 10.1111/dom.12665