Cardiovascular outcomes associated with a new once-weekly GLP-1 receptor agonist vs. traditional therapies for type 2 diabetes: a simulation analysis
| Autor: | A. V. Shcheprov, Julia A Gaebler, Kristina S. Boye, S. Bruce, B. R. Peskin, David G. Maggs |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Population Blood Pressure Type 2 diabetes Drug Administration Schedule Glucagon-Like Peptide-1 Receptor Young Adult Endocrinology Risk Factors Weight loss Internal medicine Receptors Glucagon Internal Medicine Humans Hypoglycemic Agents Medicine education Aged Macrovascular disease Aged 80 and over Glycated Hemoglobin education.field_of_study business.industry Body Weight Type 2 Diabetes Mellitus Middle Aged Nutrition Surveys medicine.disease Clinical trial Blood pressure Diabetes Mellitus Type 2 Cardiovascular Diseases Female medicine.symptom business Exenatide Diabetic Angiopathies medicine.drug |
| Zdroj: | Diabetes, Obesity and Metabolism. 13:921-927 |
| ISSN: | 1462-8902 |
| DOI: | 10.1111/j.1463-1326.2011.01430.x |
| Popis: | Aim: The effect of glucose-lowering agents on diabetes-related complications including cardiovascular (CV) events is of major importance. In the absence of a long-term study, we simulated such a trial using a mathematical model where subjects were given exenatide once-weekly (EQW), which has been shown to improve glycaemic control and reduce weight, systolic blood pressure (SBP) and lipids in patients with type 2 diabetes mellitus (T2DM). Methods: Using the Archimedes Model, we followed a simulated population derived from individuals with T2DM in NHANES who were drug-naive or on oral agents only. We modelled the effects of four treatment strategies including standard care (SC, maintaining levels of control seen in NHANES), intensive glycaemic control (IGC, target HbA1c < 7% with conventional antidiabetic agents) and two versions of EQW added to SC: one with glycaemic and weight reduction only (EQW-1) and one with additional improvements in SBP and lipids (EQW-2). EQW strategies were derived from 52-week clinical trial data. Endpoints included macrovascular and microvascular outcomes. Results: Simulated EQW treatment resulted in earlier benefit and 2–3 times greater relative reductions in major adverse CV events than IGC when compared to SC (6% relative reduction by year 20 for IGC vs. 12 and 17% for the EQW strategies). For microvascular complications, EQW showed comparable benefit to IGC for neuropathy but significantly greater impact on renal complications. Conclusions: This analysis shows that the novel drug EQW has the potential to greatly reduce CV events through its combined effects on glycaemia, weight and other CV risk factors. |
| Databáze: | OpenAIRE |
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