Glucagon-like Peptide-1 Receptor Agonists and Cardiovascular Events: Class Effects versus Individual Patterns.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
lixisenatide | no change | cardiovascular (CV) benefits | patients with Type 2 diabetes mellitus (T2D) and acute coronary syndrome | - | did not show cardiovascular (CV) benefits | #1 |
Extended-release exenatide | no change | CV outcomes | - | - | was also not significantly better | #2 |
once daily liraglutide | decrease | major adverse CV events and mortality | - | - | decreased the incidence | #3 |
once weekly semaglutide | decrease | major adverse CV events and mortality | - | - | decreased the incidence | #4 |
Several new glucose-lowering medications have been approved, such as dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and sodium glucose cotransporter-2 inhibitors. Among GLP-1RAs, lixisenatide, a short-acting drug, did not show cardiovascular (CV) benefits in patients with Type 2 diabetes mellitus (T2D) and acute coronary syndrome. Extended-release exenatide was also not significantly better for CV outcomes. By contrast, once daily liraglutide and once weekly semaglutide, both long-acting GLP-1RAs, decreased the incidence of major adverse CV events and mortality. This Review attempts to explain favorable CV results with some, but not all, GLP-1RAs, to aid in their differential prescription with the aim of further reducing the adverse CV burden of T2D.