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Heterogeneity amongst GLP-1 RA cardiovascular outcome trials results: can definition of established cardiovascular disease be the missing link?

2021-07Journal article Open access
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dc.contributor.authorMelo, Miguel
dc.contributor.authorGavina, Cristina
dc.contributor.authorSilva-Nunes, José
dc.contributor.authorAndrade, Luís
dc.contributor.authorCarvalho, Davide
dc.date.accessioned2021-08-04T09:26:17Z
dc.date.available2021-08-04T09:26:17Z
dc.date.issued2021-07
dc.description.abstractAtherosclerotic cardiovascular diseases are the leading cause of adverse outcomes in patients with type 2 diabetes, and all new anti-diabetic agents are mandated to undergo cardiovascular outcome trials (CVOTs). Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are incretin mimetics that reduce blood glucose levels with a low associated risk of hypoglycaemia. CVOTs with different GLP-1 RAs yielded different results in terms of major cardiovascular composite outcome (MACE), with some trials showing superiority in the treatment arm, whereas other simply displayed non-inferiority. More importantly, the significance of each component of MACE varied between drugs. This begs the question of whether these differences are due to dissimilarities between drugs or other factors, namely trial design, are at the root of these differences. We analyse the trial designs for all CVOTs with GLP-1 RAs and highlight important differences between them, namely in terms of the definition of established cardiovascular disease, and discuss how these differences might explain the disparate results of the trials and preclude direct comparisons between them. We conclude that a fair comparison between GLP-1 RA CVOTs would involve post-hoc analysis re-grouping the patients into different cardiovascular risk categories based upon their baseline clinical parameters, in order to even out the criteria used to classify patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMelo M, Gavina C, Silva-Nunes J, Andrade L, Carvalho D. Heterogeneity amongst GLP-1 RA cardiovascular outcome trials results: can definition of established cardiovascular disease be the missing link? Diabetol Metab Syndr. 2021;13(1):81.pt_PT
dc.identifier.doi10.1186/s13098-021-00698-5pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/13615
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMCpt_PT
dc.relation.publisherversionhttps://dmsjournal.biomedcentral.com/articles/10.1186/s13098-021-00698-5pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectCardiovascular diseasept_PT
dc.subjectAntidiabetic drugpt_PT
dc.subjectCardiovascular outcome trialspt_PT
dc.subjectGLP-1 RApt_PT
dc.subjectType 2 diabetes mellituspt_PT
dc.titleHeterogeneity amongst GLP-1 RA cardiovascular outcome trials results: can definition of established cardiovascular disease be the missing link?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage81pt_PT
oaire.citation.titleDiabetology and Metabolic Syndromept_PT
oaire.citation.volume13pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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