Potential cardiovascular effects of incretin-based therapies

Abstract

Glucagon-like peptide (GLP)-1 agonists and dipeptidyl peptidase-4 inhibitors are two classes of drugs that have been approved for treatment of Type 2 diabetes mellitus, based upon the glucose-lowering actions of the gastrointestinal hormone GLP-1. However, GLP-1 receptors are also present in cardiovascular tissues. Data from animal and in vitro studies suggest that GLP-1 may have cardioprotective effects and improve myocardial and endothelial dysfunction. Clinical data demonstrating cardiovascular effects are more limited, and there is some evidence that incretin-based therapies may be associated with improvements in cardiovascular risk factors. Large prospective cardiovascular outcome trials are underway to examine the cardiovascular safety of incretin-based therapies, and may reveal whether these agents are associated with any reduction in cardiovascular adverse events in patients with Type 2 diabetes mellitus.

Keywords::

• arteriosclerosis
• cardiovascular risk
• dipeptidyl peptidase-4
• DPP-4 inhibitor
• endothelial function
• GLP-1 agonist
• glucagon-like peptide-1
• incretin

Financial & competing interests disclosure

C Deacon has received consultancy and/or lecture fees from the following pharmaceutical companies with an interest in developing and marketing incretin-based therapies for the treatment of Type 2 diabetes mellitus (Bristol-Myers Squibb, Boehringer Ingelheim, Lilly, Merck, Novartis and Novo Nordisk). Her spouse is employed by Merck and holds stock options in Merck and Novo Nordisk. N Marx served as a speaker for Berlin Chemie, Novo Nordisk, Merck Sharp and Dohme, Boehringer Ingelheim and GlaxoSmithKline, and an advisor to GlaxoSmithKline, Merck Sharp and Dohme, Boehringer Ingelheim, Bristol-Myers Squibb and AstraZeneca. 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.