Diabetes medications with cardiovascular protection as we enter a new decade: can SGLT2 inhibitors, long-acting GLP-1 receptor agonists, pioglitazone and metformin complement each other to save lives?

Authors

  • Robert E J Ryder City Hospital, Birmingham, UK
  • Ralph A DeFronzo University of Texas Health Science Center, San Antonio, Texas, USA

DOI:

https://doi.org/10.15277/bjd.2020.250

Keywords:

type 2 diabetes, cardiovascular outcome studies, SGLT2 inhibitors, GLP-1 receptor agonists, pioglitazone, REWIND, DAPA-HF, PIONEER 6

References

Once Weekly Dulaglutide and Major Cardiovascular Events—Results of the REWIND Trial (Researching CV Events with a Weekly INcretin in Diabetes). Presented on 9 June 2019 during the 79th Scientific Sessions of the American Diabetes Association in San Francisco, USA. Slides available at http://www.phri.ca/REWIND/ (accessed 12 February 2020).

Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019;394(10193):121–30. https://doi.org/10.1016/S0140-6736(19)31149-3

Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Lancet 2019;394(10193):131–8. https://doi.org/10.1016/S0140-6736(19)31150-X

Oral Semaglutide—The PIONEER Program Trials. Presented on 11 June 2019 during the 79th Scientific Sessions of the American Diabetes Association in San Francisco, USA. Slides available at https://tracs.unc.edu/PIONEER (accessed 12 February 2020).

Husain M, Birkenfeld AL, Donsmark M, et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2019; 381(9):841–51. https://doi.org/10.1056/NEJMoa1901118

EASD VIRTUAL MEETING. Webcast: Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure (DAPA-HF). https://www.easd.org/virtualmeeting/home.html#!contentsessions/3167 (accessed 12 February 2020).

McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019;381(21): 1995–2008. https://doi.org/10.1056/NEJMoa1911303

Ryder REJ, DeFronzo RA. Diabetes medications with cardiovascular protection in the wake of EMPA-REG OUTCOME™: the optimal combination may be metformin, pioglitazone and empagliflozin. Br J Diabetes Vasc Dis 2015; 15:151–4. http://dx.doi.org/10.15277/bjdvd.2015.045

Ryder REJ, DeFronzo RA. Diabetes medications with cardiovascular protection – what now after LEADER®? Could metformin, pioglitazone, empagliflozin and liraglutide complement each other to save lives? Br J Diabetes 2016;16:103–6. http://dx.doi.org/10.15277/bjd.2016.096

Ryder REJ, DeFronzo RA. What now on the CANVAS of diabetes medications with cardiovascular protection? Could metformin, pioglitazone, SGLT2 inhibitors and liraglutide complement each other to save lives? Br J Diabetes 2017;17:89–92. http://dx.doi.org/10.15277/bjd.2017.036

Ryder REJ, DeFronzo RA. Diabetes medications with cardiovascular protection in the wake of EXSCEL – is there a class effect for long-acting GLP-1 receptor agonists? Br J Diabetes 2017;17:131–3. https://doi.org/10.15277/bjd.2017.147

Ryder REJ, DeFronzo RA. Diabetes medications with cardiovascular protection after HARMONY Outcomes and DECLARE-TIMI 58: could metformin, pioglitazone, SGLT2 inhibitors and long-acting GLP-1 receptor agonists complement each other to save lives by different mechanisms? Br J Diabetes 2019;19:1–5. https://doi.org/10.15277/bjd.2019.207

Ryder REJ. Pioglitazone has a dubious bladder cancer risk but an undoubted cardiovascular benefit. Diabet Med 2015;32:305–13. http://dx.doi.org/10.1111/dme.12627

Mazzone T, Meyer PM, Feinstein SB, et al. Effect of pioglitazone compared with glimepiride on carotid intima-media thickness in type 2 diabetes: a randomized trial. JAMA 2006;296:2572–81. http://dx.doi.org/10.1001/jama.296.21.joc60158

Nissen SE, Nicholls SJ, Wolski K, et al. Comparison of pioglitazone vs glimepiride on progression of coronary atherosclerosis in patients with type 2 diabetes: the PERISCOPE randomized controlled trial. JAMA 2008; 299:1561–73. http://dx.doi.org/10.1001/jama.299.13.1561

Ferrannini E, Mark M, Mayoux E. CV Protection in the EMPA-REG OUTCOME trial: a “thrifty substrate” hypothesis. Diabetes Care 2016;39:1108–14. http://dx.doi.org/10.2337/dc16-0330

Gautam A, Agrawal PK, Prakash P, Hazra DK. Pioglitazone associated pedal edema resolved by adding sodium glucose co-transporter 2 inhibitor. ADA 76th Scientific Sessions 2016. Late Breaking Poster Session, Poster 140-LB. Abstract 140-LB available at https://diabetes.diabetesjournals.org/content/diabetes/suppl/2016/06/20/65.Supplement_1.DC1/2016_ADA_LB_Abstracts_HiRes_FINAL_5_11_16.pdf (accessed 12 February 2020).

Abdul-Ghani MA, Puckett C, Triplitt C, et al. Initial combination therapy with metformin, pioglitazone and exenatide is more effective than sequential add-on therapy in subjects with new-onset diabetes. Results from the Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes (EDICT): a randomized trial. Diabetes Obes Metab 2015;17:268–75. http://dx.doi.org/10.1111/dom.12417

Boussageon R, Gueyffier F, Cornu C. Metformin as firstline treatment for type 2 diabetes: are we sure? BMJ 2016;352:h6748. https://doi.org/10.1136/bmj.h6748

Ryder RE. British Medical Journal Rapid Response to: Metformin as. firstline treatment for type 2 diabetes: are we sure? Available at: https://www.bmj.com/content/352/bmj.h6748/rr-2 (accessed 12 February 2020).

The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020;41:255–323. https://doi.org/10.1093/eurheartj/ehz486

Davies MJ, D'Alessio DA, Fradkin J, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018;61(12):2461–98. https://doi.org/10.1007/s00125-018-4729-5.18

Kristensen SL, Rørth R, Jhund PS, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol 2019;7(10):776–85. https://doi.org/10.1016/S2213-8587(19)30249-9

Downloads

Published

2020-06-05

Issue

Section

Editorials

Most read articles by the same author(s)

<< < 1 2