鎮ㄧ殑浣嶇疆锛?a href="http://txtcarbon.com/">棣栭〉 > 鍖昏嵂浠ｇ悊鍖昏嵂浠ｇ悊
The glucagon-like peptide (GLP) 1 receptor agonist albiglutide
provides cardioprotective benefits in patients with type 2 diabetes and
established cardiovascular disease, according to the results of the
Harmony Outcomes trial.
鈥淲hen added to standard care 鈥?the long-acting GLP-1-receptor agonist albiglutide reduced the risk of major adverse cardiovascular events with acceptable tolerability and safety. These findings provide more evidence that certain GLP-1-receptor agonists can improve cardiovascular outcomes in patients with type 2 diabetes.鈥?the investigators said.
Harmony Outcomes included 9,463 individuals (mean age 64.1 years; 31% female) with glycated haemoglobin (HbA1c) concentration >7.0% and established disease of the coronary, cerebrovascular or peripheral arterial circulation. Of these, 4,731 were assigned to receive a once-weekly subcutaneous injection of albiglutide (30 - 50 mg) and 4,732 to placebo in addition to standard care.
Over a median follow-up of 1.6 years, the primary outcome of cardiovascular death, myocardial infarction or stroke occurred in 338 (7%) patients in the albiglutide arm and in 428 (9%) patients in the placebo arm. The corresponding event rates were 4.57 and 5.87 per 100 person-years. [Lancet 2018; 392: 1519 - 1529]
Albiglutide was associated with a >20% reduction in the risk of major adverse cardiovascular events (hazard ratio, 0.78; 95%CI, 0.68 - 0.90), indicating that the drug was superior to placebo (P<0.0001 for noninferiority; P=0.0006 for superiority).
In terms of safety, the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma and other serious adverse events did not significantly differ between the two treatment arms.
鈥淭hese data suggest that certain GLP-1 receptor agonists reduce the risk of atherothrombotic events in patients with type 2 diabetes and high cardiovascular risk.鈥?according to the investigators.
鈥淭he benefit of albiglutide was evident in patients who were treated with other effective cardiovascular therapies. Despite no major difference between the treatment groups in blood pressure, bodyweight or renal function over time, treatment with [the drug] reduced the risk of major cardiovascular events over a relatively short period of follow-up.鈥?they added.
Moreover, the mean HbA1c concentration of 8.7% at baseline decreased by approximately 1% following 4 months of treatment with albiglutide vs placebo. Glucose levels remained lower in the active arm for the duration of the trial, despite a reduction over time in the placebo arm.
鈥淓vidence-based GLP-1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events, the leading cause of death and disability in patients with type 2 diabetes.鈥?the investigators said.