The Elevated Role of GLP-1 RAs in Diabetes Management: Which Patients Should We Aim For?

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Mikhail Kosiborod, MD Professor of Medicine (Cardiology)
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Presentation transcript:

The Elevated Role of GLP-1 RAs in Diabetes Management: Which Patients Should We Aim For?

Introduction/Overview

T2DM as a Risk Factor for CVD

Prevalence Rates of CV Comorbidities in Persons With T2DM: Results of a Systematic Literature Review

Mechanisms Associating Type 2 Diabetes and Cardiovascular Disease

Shorter-, Longer-Acting GLP-1 RAs: Compositional Differences and Comparative Clinical Trial Data

Molecular Structure: GLP-1, Liraglutide, Dulaglutide, Albiglutide, Exenatide, Lixisenatide, and Semaglutide

Results From SUSTAIN 1-5 (Semaglutide): Change in HbA1c

SUSTAIN 7: Changes in HbA1c and Body Weight, Semaglutide vs Dulaglutide

ELIXA: Primary Outcome: CV Death, Nonfatal MI, Nonfatal Stroke, or Hospitalization for Unstable Angina

Primary Endpoint Results From the LEADER Trial*

HARMONY OUTCOMES Primary Endpoint Results: Time to CV Death, MI or Stroke (MACE)

SUSTAIN-6 (Semaglutide): Primary Outcome Results

Dulaglutide’s Effect on the CV Composite Primary Outcome: First Occurrence of Nonfatal MI, Nonfatal Stroke, CV Death

Difference in CVOT Design: Patient Populations (Inclusion Criteria and Baseline Characteristics

CVOT Trials: Differences in Cardiovascular Risk

REWIND Results: CV Composite in Prespecified Subgroups

GLP-1 RAs and Experimental Models of CVD

Patient Preferences: Injection vs Increased Urinary Frequency

Sodium Salcaprozate (SNAC, sodium N-[8-(2-hydroxybenzoyl)amino] caprylate) Oral Absorption Promoter

PIONEER 1, 2, 3, 4, and 7: Change in HbA1c

PIONEER Clinical Development Program

PIONEER 1,5,8: Body Weight Change From Baseline: Oral Semaglutide vs Liraglutide

PIONEER 4: Estimated Mean Change From Baseline in HbA1c Oral Semaglutide vs SC Liraglutide

Will an Oral GLP-1 RA Change the Treatment Paradigm?

How Big a Problem Is Needle Phobia?

Pharmacologic Therapy for T2DM: ADA/EASD 2018 Recommendations

Patient Selection With Cardiorenal Protective Glucose-Lowering Agents

Decision Cycle for Patient-Centered Glycemic Management in Type 2 Diabetes

Summary and Conclusions

Abbreviations

Abbreviations (cont)