Longer acting GLP-1 receptor agonists and the potential for improved cardiovascular outcomes: a review of current literature

Abstract

With the rapidly rising incidence of Type 2 diabetes and an increasing variety of medications available for treatment, choosing the ideal regimen for patients can be challenging. Longer-acting glucagon-like peptide-1 (GLP-1) receptor agonists and devices have been recently developed and include once-weekly exenatide, dulaglutide, albiglutide, semaglutide and miniosmotic pump ITCA650. Some of the attractive qualities of the GLP-1 receptor agonist class include its association with weightloss and potential for cardiovascular benefits. The longer-acting forms have been shown in several studies to produce equal or greater reduction in A1c and weight compared with the standard twice-daily formulation of exenatide. They also result in lower reported incidence of nausea, in the setting of a less frequent injection schedule that would be desirable to many diabetic patients. There are emerging data to suggest patients treated with longer-acting GLP-1 receptor agonists have improved cardiac parameters, some of which are independent of weight and A1c reductions.

Keywords::

• A1c
• albiglutide
• Bydureon^®
• cardiovascular outcomes
• exenatide
• glucagon-like peptide-1
• incretins
• Type 2 diabetes
• weightloss

Financial & competing interests disclosure

RR Henry received grant support as the Principal Investigator for Bristol Myers Squibb/AstraZeneca, Johnson & Johnson/Janssen, Eli Lilly, Sanofi-aventis and Medtronics. He is on the advisory board for Amgen, Boehringer Ingelheim/Eli Lilly, Bristol Myers Squibb/AstraZeneca, Gilead, Intarcia, Johnson& Johnson/Janssen, Merck, Novo Nordisk, Roche/Genentech, sanofi-aventis, Daiichi Sankyo and Elcelyx. He is a consultant for Boehringer Ingelheim, Gilead, Intarcia, Isis, Eli Lilly, Novo Nordisk, Roche/Genentech and sanofi-aventis. All grant and research support is managed by the University of California San Diego (CA, USA) and/or Veterans Medical Research Foundation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.