Liraglutide for the prevention of major adverse cardiovascular events in diabetic patients

ABSTRACT

Introduction: The GLP-1 receptor agonist (GLP-1 RA) liraglutide has a half-life of approximately 13 h and is suitable for subcutaneous administration once daily. The use of liraglutide in people with type 2 diabetes has become popular because of the efficacy and durability in relation to glycemic control in combination with weight loss in most patients.

Areas covered: PubMed searches were completed using the terms ‘GLP-1 receptor agonist’, ‘Liraglutide’, ‘Liraglutide and CVD’, ‘Liraglutide and CVD risk factors’. The reference list of articles subsequently identified was searched and articles of interest were selected.

Expert commentary: Liraglutide has been found superior to oral antidiabetic drugs and other GLP-1 RAs with greater reductions in both HbA1c and weight except when compared with semaglutide. Liraglutide has beneficial effects on blood pressure, weight, postprandial lipids, low-grade inflammation and on the myocardium. In the cardiovascular endpoint trial LEADER liraglutide reduced the composite endpoint of cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke as well as cardiovascular and total mortality but had no effect on heart failure. Liraglutide reduces the progression of diabetic kidney disease. In the recent 2018 consensus report from EASD/ADA liraglutide is recommended to patients with established cardiovascular diseases after metformin.

KEYWORDS:

• Cardiovascular risk factors
• glycemic control
• GLP-1 RA
• kidney disease
• LEADER
• liraglutide
• weigh loss

Article highlights

• Liraglutide is a GLP-1 Receptor agonist for once-daily dosing.

• The use of liraglutide in people with type 2 diabetes have become popular because of the efficacy and durability in relation to glycemic control, low risk of hypoglycemia in combination with weight loss in most patients.

• Liraglutide has been found superior to oral antidiabetic drugs and other GLP-1 RA except compared with the GLP-1 receptor agonist semaglutide. The reduction in HbA1c with liraglutide is about 1.1 to 1.8% (12–20 mmol/mol).

• Liraglutide has beneficial effects on blood pressure, weight and postprandial lipids, low-grade inflammation and on the myocardium.

• In the cardiovascular endpoint trial LEADER liraglutide reduced the composite endpoint of cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke and cardiovascular as well as total mortality, but has no effect on heart failure.

• Liraglutide reduces the progression of diabetic kidney disease by reducing the onset of macroalbuminuria.

• In the recent consensus report from ADA/EASD liraglutide are recommended to patients with established cardiovascular diseases after metformin.

• After more than 10 years liraglutide seems to have defined its place as an effective treatment of type 2 diabetes both in patients with and without cardiovascular disease

Declaration of interest

S Madsbad is on the advisory board for AstraZeneca; Boehringer Ingelheim; Bristol-Meyers Squibb; Eli Lilly; Intarcia Therapeutics; Johnson & Johnson; Merck Sharp & Dohme; Novo Nordisk; Sanofi Aventis. He also receives lecture fees from AstraZeneca; Boehringer Ingelheim; Bristol-Meyers Squibb;Eli Lilly; Merck Sharp & Dohme; Novartis; Novo Nordisk; Sanofi Aventis and is a research grant recipient from Novo Nordisk and Boehringer-Ingelheim. The author has 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.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.