Reference: Hernandez AF, Green JB, Janmohamed S, et al. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. Lancet. 2018.Â
Adrian Hernandez, MD, and colleagues at multiple international sites have discovered that albiglutide, a glucagon-like peptide 1 receptor agonist (GLP-1 RA) used to treat type 2 diabetes mellitus (T2DM), may reduce the risk of cardiovascular (CV) events in this patient population. Click through the slides for details on their study and take home points for clinical practice.
T2DM and CV Risk. It is well known that T2DM is a significant independent risk factor for CVD and CV-related events. Several agents in the GLP-1 RA class of antihyperglycemics are known to provide cardioprotective benefits in patients with T2DM, however, it is unknown whether or not treatment with the GLP-1 RA albiglutide in T2DM has any effect on CV risk. Authors of this study sought to determine the safety and efficacy of albiglutide with respect to mortality from CV events.
The Study. Authors conducted a double-blind, randomized, placebo-controlled, multinational study looking at 9463 adults aged ≥40 years with T2DM and CVD. Patients were randomized to receive either 30-50 mg of albiglutide or a matched volume placebo once a week. The primary outcomes measured were the first occurrence of CV death, myocardial infarction, or stroke with a mean follow-up of 1.6 years.
The Results. Primary composite outcome occurred in 7% of patients in the albiglutide group and 9% of patients in the placebo group. The overall hazard ratio in the placebo group was 0.78 (95% CI 0.68-0.90) indicating superiority for albiglutide (p<.0006). Risk of adverse events (eg, pancreatic cancer, medullary thyroid carcinoma, and pancreatitis) did not differ between groups with <1% of deaths in both groups.
Take Home Points:
- Albiglutide treatment in patients with T2DM may reduce risk of CV events
- Reassure patients with T2DM that taking albiglutide is safe
- Consider use of GLP-1 RA in T2DM treatment in conjunction with comprehensive strategy to reduce risk of CV events
- Tailor treatment strategies to specific patient needs, taking into account these potential benefits
