Position Statement on cardiovascular impact of new diabetes medications published
A Position Statement on the cardiovascular impact of new diabetes medications has been published by ABCD.
The document has been drafted to help and support ABCD members and healthcare professionals who are treating people with diabetes.
Dr Ansu Basu , elected committee member, said: “After a lengthy gestation of a few years whilst new trial data became available, ABCD is, at last, pleased to announce a Position Statement on the Cardiovascular Impact of New Diabetes Medications – DPP-IV inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors.
“The ABCD position has undergone a continual evolution as new outcome trials were published, and ABCD is now able to give evidence-based best practice advice with regard to the newer anti-diabetes drugs.
“ABCD hopes that its members and all clinicians managing patients with diabetes find the advice useful in support of their day-to-day clinical decision-making.”
The key messages of the statement are as follows:
- The newer oral hypoglycaemic drugs used in diabetes have demonstrated CV safety in all cases with evidence of benefit in a few.
- There is significant heterogeneity in study design which makes meaningful comparison somewhat difficult; results of systematic reviews have indicated a common trend within drug classes. These effects are around atherosclerotic cardiovascular disease (ASCVD) using time to the first major cardiovascular event (MACE) as a primary endpoint and hospitalisation due to heart failure (HHF) as a co-primary, secondary or exploratory outcome measure.
- Only two drugs – alogliptin and lixisenatide – have been trialled in patients after acute coronary syndrome demonstrating safety. • The DPP-IV inhibitors are safe to use in those with CVD, although caution must be exercised in the presence of HF. The GLP-1 inhibitors are similarly safe and, in some cases, offer benefit.
- The SGLT2 inhibitors may be considered as the secondline antidiabetic agents of choice in the presence of HF and for reno-protection.
- Clinical judgement should always be used to make specific therapeutic choices as results from clinical trials can sometimes be difficult to generalise to individual patients.
- From the foregoing, there appears to be a genuine need now to collect data from real-world evidence to confirm or challenge the findings from the clinical trials
To read the statement, click here.