T2D: effects of liraglutide and sitagliptin on cardiovascular function

  • Webb DR & al.
  • Diabetes Obes Metab
  • 10 Mar 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In young obese patients with type 2 diabetes (T2D), short-term use of liraglutide was associated with greater weight loss and glucose control compared with sitagliptin.
  • Liraglutide and sitagliptin did not show significant effects on cardiovascular structure or function.

Why this matters

  • Longer studies may be necessary before definitive conclusions can be made about putative pleiotropic properties of incretin-based therapies in patients with more severe cardiac dysfunction.

Study design

  • The LYDIA trial of 76 obese patients with T2D who were randomly assigned to received liraglutide (n=38) or sitagliptin (n=38).
  • Primary outcome: difference in circumferential peak early-diastolic strain rate change (PEDSR)
  • Funding: Novo Nordisk.

Key results

  • After 26 weeks, no significant difference was observed between liraglutide and sitagliptin in:
    • PEDSR (intervention effect, -0.01 [95% CI, -0.07 to 0.06] second-1; P=.874);
    • left ventricular ejection fraction (intervention effect, -1.98 [95% CI, -4.90 to 0.94] %; P=.183) and mass (intervention effect, 1.14 [95% CI, -5.23 to 7.50] g; P=.308); and
    • aortic distensibility (intervention effect, -0.35 [95% CI, -0.98 to 0.28] mmHg-1x10-3; P=.275).
  • Liraglutide vs sitagliptin had:
    • greater reduction in haemoglobin A1c (intervention effect, -4.57 [95% CI, -9.10 to -0.37] mmoLmoL-1; P=.048) and body weight (intervention effect, -3.88 [95% CI, -5.74 to -2.01] kg; P=.001); and
    • a significant reduction in alanine Transaminase (intervention effect, -11.27[95% CI, -20.17 to -2.37] IUl-1; P=.013).

Limitations

  • Study did not compare individual drug effects with control.