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Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: A systematic review and meta-analysis of cardiovascular outcome trials

The Lancet Diabetes & Endocrinology Sep 25, 2019

Kristensen SL, Rørth R, Jhund PS, et al. - Given that glucagon-like peptide-1 (GLP-1) receptor agonists vary in their structure and duration of action and have been studied in trials of differing sizes and with different patient populations, with inconsistent impacts on cardiovascular results reported, researchers synthesized the available evidence by conducting a systematic review and meta-analysis of cardiovascular outcome trials of these drugs. For eligible placebo-controlled trials reporting major adverse cardiovascular events (MACE; ie, cardiovascular death, stroke, or myocardial infarction) up to June 15, 2019, MEDLINE (via PubMed) and the Cochrane Central Register of Controlled Trials were searched. The study sample consisted of 56,004 candidates. Investigators found that GLP-1 receptor agonist treatment decreased all-cause mortality by 12%, hospital admission for heart failure by 9%, and a broad composite kidney outcome (development of new-onset macroalbuminuria, decline in estimated glomerular filtration rate [or increase in creatinine], progression to end-stage kidney disease, or death attributable to kidney causes) by 17%, mainly due to a decline in urinary albumin excretion. In patients with T2D, treatment with GLP-1 receptor agonists has beneficial impacts on cardiovascular, mortality, and kidney outcomes. No risks of severe hypoglycaemia, pancreatitis, or pancreatic cancer have been increased.
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