Early impact of liraglutide in routine clinical use (ABCD nationwide liraglutide audit) on cardiovascular risk (UKPDS risk engine)

Chris Walton, Saiful Kassim, Roy Harper, Paula McDonald, Ursula Brennan, Janet Harding, Thein Htay, Rahul Nayar, Andrew Pernet, Susannah Rowles, Karen Adamson, Ken Y Thong, Robert E J Ryder, On behalf of ABCD nationwide liraglutide audit contributors

Abstract


Aims: Liraglutide has been shown to reduce cardiovascular mortality in a cardiovascular safety study, but it is not known to what extent these results will be replicated in real practice with people with diabetes treated with liraglutide in the UK. We wished to explore the likely cardiovascular benefits by modelling 10-year reduction in cardiovascular events and mortality using data from the ABCD liraglutide audit database.

Methods: The UKPDS risk engine 2.0 was applied to data collected in the ABCD liraglutide audit database before and at the earliest return to clinic between 3 and 9 months after commencing liraglutide, using the 747 of 6,959 records where all factors used by the risk engine were completely recorded.

Results: There were significant falls in all factors used in the UKPDS cardiovascular disease (CVD) risk assessment other than HDL cholesterol which was unchanged. The UKPDS risk engine mean±SD 10-year coronary heart disease (CHD) risk fell by 2.7±7.6% from 18.7±13.0% to 16.1±11.6% (p<0.001). The 10-year fatal CHD risk fell by 2.3±6.5% from 13.7±11.1% to 11.4±9.8% (p<0.001). The 10-year stroke risk fell by 0.3±2.8% from 7.9±8.7% to 7.6±8.3% (p=0.003). The 10-year fatal stroke risk fell by 0.1±0.7% from 1.2±1.4% to 1.1±1.3% (p=0.001).

Conclusion: Starting liraglutide reduced 10-year CVD risk. These data suggest that liraglutide used in routine clinical care in 100 patients could prevent three events of CHD or stroke and save two or more lives over the next 10 years.


Keywords


liraglutide, cardiovascular risk, ABCD ationwide audit, UKPDS risk engine, numbers needed to treat

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References


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DOI: https://doi.org/10.15277/bjd.2020.243

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