T2D: effects of liraglutide and sitagliptin on cardiovascular function

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.