Cardiovascular safety and benefits of GLP-1 receptor agonists

Jan 20, 2017Expert opinion on drug safety

Heart safety and benefits of GLP-1 receptor agonists

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GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

Six different GLP-1 receptor agonists (GLP-1RAs) are approved for treating type 2 diabetes.

GLP-1RAs improve glycemic control and are associated with weight loss and a low risk of hypoglycemia.
Lixisenatide has been shown to be safe for patients with type 2 diabetes and recent acute coronary syndrome.
Liraglutide and semaglutide may reduce cardiovascular disease risk in type 2 diabetes patients with established or high risk of cardiovascular disease.
The cardiovascular safety of other GLP-1RAs in high-risk type 2 diabetes patients is currently uncertain.
Ongoing cardiovascular outcome trials are expected to provide further insights into the safety and efficacy of GLP-1RAs.

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Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) constitute a class of drugs for the treatment of type 2 diabetes, and currently, six different GLP-1RAs are approved. Besides improving glycemic control, the GLP-1RAs have other beneficial effects such as weight loss and a low risk of hypoglycemia. Treatment with the GLP-1RA lixisenatide has been shown to be safe in patients with type 2 diabetes and recent acute coronary syndrome. Furthermore, liraglutide and semaglutide have been shown to reduce cardiovascular (CV) disease (CVD) risk in type 2 diabetes patients with established and/or high risk of CVD. The CV safety of the remaining GLP-1RAs in type 2 diabetes patients with established and/or high risk of CVD remains uncertain, but ongoing CV outcome trials (CVOTs) will elucidate this within a few years. Areas covered: The aim of this review is to provide an overview of the existing GLP-1RAs with a particular focus on their clinical effects on CV risk factors and their CV safety and benefits. Expert opinion: Data on the CV risks and benefits associated with GLP-1RA treatment in patients with type 2 diabetes and high risk of CVD are emerging - and look promising (especially for liraglutide and semaglutide). Data from ongoing CVOTs will be crucial for the positioning of the individual GLP-1RAs in the treatment of patients with type 2 diabetes and high risk of CVD. However, the long-term CV safety and the potential of GLP-1RAs to prevent CVD in type 2 diabetes patients with less risk of CVD (e.g. newly diagnosed patients) remain uncertain.

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Cardiovascular safety and benefits of GLP-1 receptor agonists

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