ADA 2019—Dulaglutide reduces CVD risk in T2D regardless of previous CVD status


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • Once weekly injections of the glucagon-like peptide-1 receptor agonist dulaglutide reduces cardiovascular disease (CVD) risk for middle-aged and older patients with type 2 diabetes (T2D).
  • Risk is reduced regardless of baseline CVD status or risk factors among patients in the REWIND trial.

Why this matters

  • Adding this drug to existing antihyperglycemic regimens in older patients with T2D “should be considered,” say these authors.
  • Health care providers will welcome the findings of this ambitious trial, study lead investigators said in a statement. 

Key results

  • Primary outcome (first occurrence of composite of nonfatal myocardial infarction/stroke, or death from cardiovascular causes, including unknown causes) occurred in:
    • 12.0% with dulaglutide vs 13.4% with placebo.
    • Incidence rate: 2.4/100 person-years with drug vs 2.7/100 person-years with placebo.
    • HR, 0.88 (95% CI, 0.79-0.99; P=.026).
  • No difference in all-cause mortality: HR, 0.90 (95% CI, 0.80-1.01; P=.067).
  • 47.4% in drug group had a gastrointestinal event during follow-up (median 5.4 years) vs 34.1% with placebo (P<.0001>

Study design

  • Multicenter (371 sites; 24 countries), randomized, double-blind, placebo-controlled trial involving 9901 participants (4949 dulalglutide; 4952 placebo).
  • Funding: Eli Lilly and Company.

Limitations

  • 1 in 4 participants was not taking the study drug at their last visit.

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