Glucagon-like peptide-1 receptor agonists and sodium−glucose cotransporter 2 inhibitors for cardiovascular and renal protection: A treatment approach far beyond their glucose-lowering effect

In 2008 the Food and Drug Administration has revised approval process for new antidiabetic agents and introduced a requirement to demonstrate the cardiovascular safety in an international multicenter trial. Currently cardiovascular outcome trials of dipeptidyl peptidase-4 (DPP-4) inhibitors (SAVOR-TIMI53, EXAMINE and TECOS), sodium-glucose cotransporter 2 inhibitors (EMPAREG, CANVAS), glucagon-like peptide-1 receptor agonists (ELIXA, EXSCEL LEADER and SUSTAIN-6), ultralong-acting and insulin (DEVOTE) have been completed. The trials confirmed cardiovascular safety of these glucose-lowering medications, and in addition, EMPA-REG OUTCOME (empagliflozin), CANVAS (canagliflozin) and LEADER (liraglutide) have also demonstrated cardioprotective effect of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. These data led to the changes of clinical guidelines for the management of type 2 diabetes.

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Involvement of glucagon-like peptide-1 in the glucose-lowering effect of metformin

Diabetes Obesity and Metabolism ◽

10.1111/dom.12697 ◽

2016 ◽

Vol 18 (10) ◽

pp. 955-961 ◽

Cited By ~ 29

Author(s):

Emilie Bahne ◽

Morten Hansen ◽

Andreas Brønden ◽

David P. Sonne ◽

Tina Vilsbøll ◽

...

Keyword(s):

Glucose Lowering ◽

Lowering Effect ◽

Glucose Lowering Effect ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

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438-P: Comparative Cardiovascular Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists vs. Other Glucose-Lowering Agents in Patients with Type 2 Diabetes—A Nationwide Cohort Study Using Prevalent New-User Design

Diabetes ◽

10.2337/db19-438-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 438-P

Author(s):

CHUN-TING YANG ◽

CHENYI YANG ◽

SHIHCHEN KUO ◽

HUANG-TZ OU

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Glucose Lowering ◽

Receptor Agonists ◽

User Design ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

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Efficacy and cardiovascular safety of SGLT2 Inhibitors

Current Drug Safety ◽

10.2174/1574886315666201002154640 ◽

2020 ◽

Vol 15 ◽

Author(s):

Cornelius James Fernandez ◽

Abisha Graciano Nevins ◽

Shasta Nawaz ◽

Tahir Nazir ◽

Fahmy W F Hanna

Keyword(s):

Decision Process ◽

Cardiovascular Events ◽

Unmet Need ◽

Clinical Decision ◽

Sglt2 Inhibitors ◽

Renal Protection ◽

Sodium Glucose Cotransporter ◽

Patients With Diabetes ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

: Patients with diabetes continued to exhibit a high risk for cardiovascular and renal events despite achieving satisfactory glycemic, blood pressure and lipid targets. Studies evaluating new diabetes medications focused on cardiovascular events, largely overlooking heart failure (HF). The latter has recently been recognised as a major cause of morbidity and mortality in patients with diabetes mellitus. There had been an unmet need for drugs with cardiovascular (including HF) and renal protection, with an expectation that an ideal diabetic drug should improve these end points. Moreover, an ideal drug should have weight lowering benefits. Recently published outcome trials have shown that sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1RAs) can reduce cardiovascular and renal events, together with statistically significant weight reduction. As a result, many recently published international guidelines have recommended SGLT2 inhibitors and GLP-1RAs in patients with diabetes and pre-existing cardiovascular disease (CVD). In this review we will critically analyse the efficacy and cardiovascular (CV) safety of SGLT2 inhibitors, based on the available literature to help position them in the clinical decision process.

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Glucagon Like Peptide‐1 Receptor Agonists and Sodium‐Glucose Cotransporter 2 Inhibitors for Diabetes After Solid Organ Transplantation

Transplant International ◽

10.1111/tri.13883 ◽

2021 ◽

Author(s):

Lale A. Ertuglu ◽

Esteban Porrini ◽

Mads Hornum ◽

Atalay Demiray ◽

Baris Afsar ◽

...

Keyword(s):

Organ Transplantation ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Receptor Agonists ◽

Sodium Glucose Cotransporter ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

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The Use of SGLT2i and GLP-1 RA in Patients with Type 2 Diabetes in Thailand: Evidence Review and Recommendations

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.11.13163 ◽

2021 ◽

Vol 104 (11) ◽

pp. 1850-1865

Keyword(s):

Type 2 Diabetes ◽

Glucose Lowering ◽

Sodium Glucose Cotransporter ◽

Evidence Review ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Glucose Lowering Therapy ◽

The Cost ◽

Selection Of

Background: Cardiovascular (CV) and renal comorbidities are common among type 2 diabetes (T2D) patients, and significantly increase the cost and burden of care. Both sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve key outcomes including major CV events, hospitalization for heart failure, and renal outcomes, albeit to varying degrees in different T2D populations. Materials and Methods: The authors reviewed evidence from GLP-1 RA and SGLT2i CV outcomes trials and real-world studies in Thailand and elsewhere. Results: The authors formulated recommendations to guide selection of anti-diabetes medication based on patients’ clinical characteristics and CV or renal risk profile. Conclusion: These recommendations could help guide management of CV/renal comorbidities and risk alongside glucose-lowering therapy for individual patients. Keywords: Type 2 diabetes mellitus; Cardiovascular diseases; Chronic kidney disease; Clinical outcomes; SGLT2i; GLP-1 RA

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