Liraglutide relieves cardiac dilated function than <scp>DPP</scp>‐4 inhibitors

Hiramatsu, Takeyuki; Asano, Yuko; Mabuchi, Masatsuna; Imai, K; Iguchi, Daiki; Furuta, Shunsuke

doi:10.1111/eci.13007

Cited by 15 publications

(19 citation statements)

References 29 publications

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“…At baseline, the median trial mean glycated haemoglobin A1c was 8.1% and BMI was 30.1. Eligibility criteria included coronary artery disease or macrovascular disease in 35 trials, 3 6 7 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 atrial fibrillation in 1 trial, 65 heart failure in 9 trials, 66 67 68 69 70 71 72 73 74 chronic kidney disease and/or albuminuria in 37 trials, 8 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 …”

Section: Resultsmentioning

confidence: 99%

Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials

Palmer

Tendal

Mustafa

et al. 2021

BMJ

419

310

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Objective To evaluate sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in patients with type 2 diabetes at varying cardiovascular and renal risk. Design Network meta-analysis. Data sources Medline, Embase, and Cochrane CENTRAL up to 11 August 2020. Eligibility criteria for selecting studies Randomised controlled trials comparing SGLT-2 inhibitors or GLP-1 receptor agonists with placebo, standard care, or other glucose lowering treatment in adults with type 2 diabetes with follow up of 24 weeks or longer. Studies were screened independently by two reviewers for eligibility, extracted data, and assessed risk of bias. Main outcome measures Frequentist random effects network meta-analysis was carried out and GRADE (grading of recommendations assessment, development, and evaluation) used to assess evidence certainty. Results included estimated absolute effects of treatment per 1000 patients treated for five years for patients at very low risk (no cardiovascular risk factors), low risk (three or more cardiovascular risk factors), moderate risk (cardiovascular disease), high risk (chronic kidney disease), and very high risk (cardiovascular disease and kidney disease). A guideline panel provided oversight of the systematic review. Results 764 trials including 421 346 patients proved eligible. All results refer to the addition of SGLT-2 inhibitors and GLP-1 receptor agonists to existing diabetes treatment. Both classes of drugs lowered all cause mortality, cardiovascular mortality, non-fatal myocardial infarction, and kidney failure (high certainty evidence). Notable differences were found between the two agents: SGLT-2 inhibitors reduced mortality and admission to hospital for heart failure more than GLP-1 receptor agonists, and GLP-1 receptor agonists reduced non-fatal stroke more than SGLT-2 inhibitors (which appeared to have no effect). SGLT-2 inhibitors caused genital infection (high certainty), whereas GLP-1 receptor agonists might cause severe gastrointestinal events (low certainty). Low certainty evidence suggested that SGLT-2 inhibitors and GLP-1 receptor agonists might lower body weight. Little or no evidence was found for the effect of SGLT-2 inhibitors or GLP-1 receptor agonists on limb amputation, blindness, eye disease, neuropathic pain, or health related quality of life. The absolute benefits of these drugs vary substantially across patients from low to very high risk of cardiovascular and renal outcomes (eg, SGLT-2 inhibitors resulted in 5 to 48 fewer deaths in 1000 patients over five years; see interactive decision support tool ( https://magicevidence.org/match-it/200820dist/#!/ ) for all outcomes. Conclusions In patients with type 2 diabetes, SGLT-2 inhibitors and GLP-1 receptor agonists reduced cardiovascular and renal outcomes, with notable differences in benefits and harms. Absolute benefits are determined by individual risk profiles of patients, with clear implications for clinical practice, as reflected in the BMJ Rapid Recommendations directly informed by this systematic review. Systematic review registration PROSPERO CRD42019153180.

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Section: Resultsmentioning

confidence: 99%

Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials

Palmer

Tendal

Mustafa

et al. 2021

BMJ

419

310

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“… 22 , 23 Liraglutide and SGLT-2 inhibitors were reported to improve cardiac diastolic dysfunction. 24 , 25 Strong and sustained glycemic control by liraglutide may reduce albuminuria and improve cardiac function, reflected by BNP, LVMI, LAD, and E/e’. 24 Also, both drugs induce less hypoglycemic attacks and decreased glycemic fluctuation.…”

Section: Discussionmentioning

confidence: 99%

“…24,25 Strong and sustained glycemic control by liraglutide may reduce albuminuria and improve cardiac function, reflected by BNP, LVMI, LAD, and E/e'. 24 Also, both drugs induce less hypoglycemic attacks and decreased glycemic fluctuation. 26,27 Such improved glycemic control may reduce oxidative stress and inflammation, which aside from glycemic control reduces atherosclerosis in patients taking GLP-1 RA and SGLT-2 inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Impact of glucagon like peptide-1 receptor agonist and sodium glucose cotransporter 2 inhibitors on type 2 diabetes patients with renal impairment

Hiramatsu

Ito

Okumura

et al. 2020

Diabetes and Vascular Disease Research

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Introduction: Diabetes mellitus is a progressive disease with cardiovascular complications. We evaluated the impact of a glucagon like peptide-1 (GLP-1) receptor agonist and sodium glucose cotransporter 2 (SGLT-2) inhibitors dapagliflozin and empagliflozin on renal and cardiac function in type 2 diabetes patients with renal impairment. Materials and methods: A total of 156 patients referred with suboptimal glycemic control were assigned to Group G (GLP-1): n = 72 or Group S (SGLT-2 inhibitor)—dapagliflozin ( n = 52) or empagliflozin ( n = 32). Renal function was assessed every 3 months for 36 months. Cardiovascular parameters were evaluated every 12 months for 36 months. Results: Compared with baseline, HbA1c and systolic blood pressure significantly decreased in both groups ( p < 0.05). The estimated glomerular filtration rate decreased, but without significance. Albuminuria decreased significantly in both groups and then subsequently increased after 30 months in Group S. Diastolic cardiac function, assessed by E/e′ or left atrial volume index, decreased only in Group G at 36 months. Conclusions: The GLP-1 receptor agonist and SGLT-2 inhibitors were effective for glycemic and blood pressure control and for maintaining renal function. The GLP-1 receptor agonist improved diastolic function at 36 months.

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“…In the literature search, 19,096 articles were extracted, and 8 RCTs (592 patients) met the eligibility criteria for the study and were included in the meta-analysis (Fig. 1) [12][13][14][15][26][27][28]. The characteristics of the eight studies are shown in Table 1, and a network map is shown in Fig.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Effects of oral antidiabetic drugs and glucagon-like peptide-1 receptor agonists on left ventricular diastolic function in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis

et al. 2020

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The present study aimed to compare the effects of oral antidiabetic drugs (OADs) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) on left ventricular diastolic function in patients with type 2 diabetes mellitus using a network meta-analysis of randomized controlled trials (RCTs). Literature searches were conducted on Medline, the Cochrane Controlled Trials Registry, and ClinicalTrials.gov. RCTs that assessed the effects on left ventricular diastolic function of OADs and GLP-1RAs in patients with type 2 diabetes were included. The outcome was the value (E/e') obtained by dividing peak early diastolic transmitral flow velocity (E) by the mitral annular early diastolic velocity (e'). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated from a random-effects network meta-analysis. Eight RCTs (592 patients) identified in a literature search met the eligibility criteria for this study and were included in the network meta-analysis. Compared with placebo, liraglutide was the only drug that caused a significant improvement in left ventricular diastolic function (SMD, − 0.65; 95% CI, − 1.23 to − 0.08). In addition, when the effects on left ventricular diastolic function were evaluated across drugs, liraglutide alone caused a significant improvement in left ventricular diastolic function compared with OADs (sitagliptin, linagliptin, pioglitazone, rosiglitazone, voglibose, and glimepiride). From the perspective of preventing the onset of heart failure, the administration of liraglutide for type 2 diabetes is promising. Keywords Antidiabetic drugs . Network meta-analysis . Randomized controlled trials . Type 2 diabetes mellitus . Left ventricular diastolic function Abbreviations CI Confidence interval HFpEF Heart failure with preserved ejection fraction LVDD Left ventricular diastolic dysfunction MACE Major cardiovascular events PRISMA Preferred reporting items for systematic reviews and meta-analysis RCT Randomized controlled trials SD Standard deviation SE Standard error SMD Standardized mean differences Electronic supplementary material The online version of this article (

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Liraglutide relieves cardiac dilated function than DPP‐4 inhibitors

Cited by 15 publications

References 29 publications

Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials

Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials

Impact of glucagon like peptide-1 receptor agonist and sodium glucose cotransporter 2 inhibitors on type 2 diabetes patients with renal impairment

Effects of oral antidiabetic drugs and glucagon-like peptide-1 receptor agonists on left ventricular diastolic function in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis

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