GLP-1 treatment benefits patients on statins and with varying LDL levels.
Low-density lipoprotein cholesterol (LDL) is negatively linked to cardiovascular events. People with type 2 diabetes especially have increased risk of atherosclerotic damage and it is highly recommended these patients take statins to lower LDL levels. Suggested target LDL levels in people with type 2 are below 100 mg/dL for high-risk patients, less than 70 mg/dL for very high-risk patients, and less than 55 mg/dL for patients at extreme risk. Liraglutide is a GLP-1 agonist antidiabetes medication that has shown to help with weight loss. The focus of a new study was to see if it had cardiovascular benefits as well.
A randomized trial called Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) was conducted to research if liraglutide has any cardiovascular benefit in patients with type 2 diabetes. The study enrolled 9,340 people who have type 2 and high cardiovascular risk and randomized them into two groups. One group received 1.8 mg or more of liraglutide while the other group received a placebo. Median follow-up was 3.8 years. Primary outcomes were cardiovascular death, nonfatal myocardial infarction, or nonfatal stoke. At baseline, 926 patients had LDL levels <50 mg/dL, 2021 had 50-70 mg/dL, and 6,240 patients had >70 mg/dL. Also at baseline, 72% of participants were on a statin with an additional 10% adding a statin during treatment.
Results of this study showed higher baseline LDL did correlate to more risk of cardiovascular events as predicted. There were 11.7% in the <50mg/dL group who experienced an event, while 14.2% in >70mg/dL had an event. Among all three groups, those taking liraglutide had reduced risk of a cardiovascular event. In a sensitivity analysis, patients with LDL-C divided at baseline above and below the median of 84.2 mg/dL, liraglutide reduced cardiovascular events in both groups (hazard ratio, 0.88 [95% CI, 0.76–1.03] and 0.86 [95% CI, 0.73–1.01], respectively. The hazard ratio for liraglutide versus placebo for CV events was 0.83 (95% CI, 0.73–0.95) in statin users and 0.97 (95% CI, 0.79–1.20) in nonusers.
These findings suggest liraglutide is beneficial on cardiovascular outcomes and mortality in people with type 2 diabetes who have a high cardiovascular risk. The benefits were seen in patients no matter what their LDL levels were and even if they were using statins. Liraglutide, a GLP-1 agonist, helped to lower lipid levels and reduce cardiovascular risk. With these CV benefits along with weight reduction, GLP-1 agonists are a good option for people who have type 2 diabetes and cardiovascular risks.
- Liraglutide is a GLP-1 agonist that has shown to help with weight loss and new research now shows it is beneficial on cardiovascular health as well.
- No matter what a patient’s LDL level is, liraglutide reduced risk of cardiovascular events.
- Liraglutide cam be used alongside statins to achieve optimal risk reduction.
Subodh Verma, Lawrence A. Leiter, C. David Mazer, Stephen C. Bain, John Buse, Steve Marso, Michael Nauck, Bernard Zinman, Heidrun Bosch-Traberg, Soren Rasmussen, Marie M. Michelsen, Deepak L. Bhatt. Liraglutide Reduces Cardiovascular Events and Mortality in Type 2 Diabetes Mellitus Independently of Baseline Low-Density Lipoprotein Cholesterol Levels and Statin Use. Circulation (2018);138:00–00. DOI: 10.1161/CIRCULATIONAHA.118.036862
Angela Reyes, Pharm.D. Candidate, LECOM College of Pharmacy