Effect of race on cardiometabolic responses to once-weekly exenatide: insights from the Exenatide Study of Cardiovascular Event Lowering (EXSCEL).

Autor: Davis TME; Medical School, University of Western Australia, Fremantle Hospital, P.O. Box 480, Fremantle, WA, Australia. tim.davis@uwa.edu.au., Giczewska A; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA., Lokhnygina Y; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA., Mentz RJ; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA., Sattar N; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Holman RR; Diabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Jazyk: angličtina
Zdroj: Cardiovascular diabetology [Cardiovasc Diabetol] 2022 Jun 27; Vol. 21 (1), pp. 116. Date of Electronic Publication: 2022 Jun 27.
DOI: 10.1186/s12933-022-01555-z
Abstrakt: Background: To determine whether there were racial differences in short-term cardiometabolic responses to once-weekly exenatide (EQW) in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL).
Methods: EXSCEL enrolled 14,752 patients with type 2 diabetes (hemoglobin A 1c (HbA 1c ) 6.5-10.0% [48-86 mmol/mol]) with or without cardiovascular disease who were randomized double-blind to EQW or placebo. Background glucose-lowering/other cardiovascular therapies were unaltered for 6 months post-randomization unless clinically essential, facilitating comparison of EQW-associated effects in 14,665 evaluable participants self-identifying as White (n = 11,113), Asian (n = 1444), Black (n = 870), or Other Race (n = 1,238. Placebo-adjusted 6 month absolute changes in cardiometabolic variables were assessed using generalized linear models.
Results: Mean 6-month placebo-adjusted HbA 1c reductions were similar in the four groups (range 0.54-0.67% [5.9 to 7.3 mmol/mol], P = 0.11 for race×treatment interaction), with no significant difference in Asians (reference) versus other groups after covariate adjustment (all P ≥ 0.10). Six-month placebo-adjusted mean changes in systolic (-1.8 to 0.0 mmHg) and diastolic (0.2 to 1.2 mmHg) blood pressure, serum LDL (- 0.06 to 0.02 mmol/L) and HDL (0.00 to 0.01 mmol/L) cholesterol, and serum triglycerides (-0.1 to 0.0 mmol/L) were similar in the racial groups (P ≥ 0.19 for race×treatment interaction and all P ≥ 0.13 for comparisons of Asians with other races). Resting pulse rate increased more in Asians (4 beats/min) than in other groups (≤ 3 beats/min, P = 0.016 for race×treatment interaction and all P ≤ 0.050 for comparisons of Asians with other races).
Conclusions: Short-term cardiometabolic responses to EQW were similar in the main racial groups in EXSCEL, apart from a greater pulse rate increase in Asians.
Trial Registration: https://clinicaltrials.gov NCT01144338.
(© 2022. The Author(s).)
Databáze: MEDLINE
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