Effect of glucagon‐like peptide‐1 receptor agonists in subjects with type 2 diabetes mellitus: A meta‐analysis

• Published in: Journal of clinical pharmacy and therapeutics Vol. 46; no. 6; pp. 1650 - 1658
• Main Authors: Qian, Weiyun, Liu, Fei, Yang, Qichao
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.12.2021
• Subjects: Agonists; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cardiovascular Diseases - pathology; Cardiovascular System - drug effects; Cerebral infarction; Congestive heart failure; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - mortality; eye; Eye - drug effects; Eye Diseases - mortality; Eye Diseases - pathology; GLP-1 receptor agonists; Glucagon; Glucagon-Like Peptide-1 Receptor - agonists; Heart failure; Hospitalization - statistics & numerical data; Humans; kidney; Kidney - drug effects; Kidney Diseases - mortality; Kidney Diseases - pathology; Kidneys; Meta-analysis; Mortality; mortality; cardiovascular; Myocardial infarction; Peptides; Placebos; Randomized Controlled Trials as Topic; Renal failure; Retrospective Studies; type 2 diabetes mellitus; eye; type 2 diabetes mellitus; kidney; mortality; cardiovascular; glucagon-like peptide-1 receptor agonists
• ISSN: 0269-4727; 1365-2710; 1365-2710
• DOI: 10.1111/jcpt.13502

What is known and objective We performed a meta‐analysis to evaluate the effects of glucagon‐like peptide‐1 receptor agonists compared to placebo on cardiovascular, kidney‐related, and eye‐related disease outcomes or on mortality in subjects with type 2 diabetes mellitus. Methods A systematic literature search up to April 2021 was performed, and 8 studies included 61,661 subjects with type 2 diabetes mellitus at the start of the study, 29,034 of them were using glucagon‐like peptide‐1 receptor agonists and 32,627 were given a placebo. They reported on relationships between the effects of glucagon‐like peptide‐1 receptor agonists compared to placebo on mortality rates, cardiovascular, renal and ophthalmic outcomes in subjects with type 2 diabetes mellitus. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to assess the effects of glucagon‐like peptide‐1 receptor agonists compared to placebo on the listed outcomes on subjects with type 2 diabetes mellitus, using the dichotomous method with a random or fixed‐effect model. Results The use of glucagon‐like peptide‐1 receptor agonists was associated with significantly lowered all‐cause mortality (OR, 0.76; 95% CI, 0.65–0.89, p < 0.001), cardiovascular deaths (OR, 0.87; 95% CI, 0.81–0.94, p < 0.001), myocardial infarctions (OR, 0.92; 95% CI, 0.85–0.98, p = 0.01), strokes (OR, 0.81; 95% CI, 0.74–‐0.90, p < 0.001), hospital admissions owing to heart failure (OR, 0.91; 95% CI, 0.83–1.00, p = 0.04) and renal events (OR, 0.83; 95% CI, 0.77–0.89, p < 0.001) compared to placebo in subjects with type 2 diabetes mellitus. However, glucagon‐like peptide‐1 receptor agonists had significantly higher ophthalmic events (OR, 1.15; 95% CI, 1.04–1.29, p = 0.009) compared to placebo in subjects with type 2 diabetes mellitus. What is new and conclusion Glucagon‐like peptide‐1 receptor agonists may have a lower risk of all‐cause mortality, cardiovascular death, myocardial infarction, stroke, hospital admission owing to heart failure and renal events compared to placebo in subjects with type 2 diabetes mellitus. However, they have significantly higher ophthalmic events compared to placebo in subjects with type 2 diabetes mellitus. Further studies are required to validate these findings. The effects of glucagon‐like peptide‐1 receptor agonists on mortality, cardiovascular, kidney, eye outcomes in subjects with type 2 diabetes mellitus are conflicting. The meta‐analysis presented here was to assess this relationship.