- Glucagon-like peptide-1 receptor agonists (GLP1RAs) offer significant cardiovascular (CV) safety benefits, according to an analysis of data from CV outcomes trials.
- An indirect comparison across trials suggests once-weekly semaglutide and oral semaglutide may be preferred GLP1RAs in patients with type 2 diabetes (T2D) with established or at high risk for CV disease (CVD).
Why this matters
- No head-to-head trials compare CV outcomes among different GLP1RAs.
- Indirect comparison of data from 7 GLP1RA CV outcomes trials, including 56,004 patients with T2D and established CVD or risk factors.
- Funding: King Saud University, Riyadh, Saudi Arabia.
- With weekly injected semaglutide vs lixisenatide, significant reductions seen in major adverse cardiovascular events (MACE): OR, 0.71 (95% CI, 0.52-0.96).
- MACE risk reductions also seen with albiglutide vs lixisenatide: OR, 0.76 (95% CI, 0.61-0.93).
- Weekly semaglutide had highest probability of ranking first in MACE reduction (52%) followed by oral semaglutide (26%) and albiglutide (20%).
- CV mortality (ORs; 95% CIs) was significantly reduced with:
- Semaglutide vs exenatide: 0.47 (0.21-0.99).
- Semaglutide vs dulaglutide: 0.46 (0.20-0.97).
- Semaglutide vs albiglutide: 0.45 (0.19-0.97).
- Semaglutide vs lixisenatide: 0.43 (0.19-0.92).
- Semaglutide also had the highest probability of ranking first (>90%) in CV mortality reduction.
- Intertrial differences in study populations, MACE component results.
- Albiglutide is no longer available.
- Other decision-making parameters, such as cost, weight reduction, and glycemic control not addressed.