A meta-analysis of cardiovascular safety of GLP-1 receptor agonists for diabetes / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the cardiovascular safety of glucagon-like peptide-1 receptor agonists (GLP-1 RA) for diabetes systematically. METHODS: Medline, Embase, ClinicalTrails. gov, Cochrane Liabrary, CBM, and CNKI were retrieved to collect all the randomized controlled trials (RCT) with a duration of at least 24 weeks, comparing a GLP-1 RA with a non-GLP-1 RA agent in type 2 diabetes, and then a Meta-analysis was performed with RevMan5.3 software. RESULTS: Fifty-one RCTs, invovling 26140 individuals with type 2 diabetes, were included in the analysis. The difference in the incidence of major adverse cadiovascular events (MACE) between GLP-1 RA and comparators did not reach statistical significance, and the odds ratio was 0.78 (0.57, 1.08), although a favorable trend was observed; while in comparisons with placebo, the incidence of MACE was significantly decreased and the odds ratio was 0.5 (0.28, 0.87); compared with comparators, a significant decrease of the incidence of all-cause and cardiovascular mortality were detected and the odds ratio were 0.53 (0.27, 0.93) and 0.38 (0.16, 0.90), respectively. As for the cardiovascular risk factors, GLP-1 RA significantly decreased the HbA1c, weight, TG, LDL, SBP, but increased the heart rates. CONCLUSION: GLP-1 RA may have a protective effect on cardiovascular diseases, compared with the comparators, especially compared with placebo.