Long-term changes in cardiovascular risk markers during administration of exenatide twice daily or glimepiride: results from the European exenatide study
Objective The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes tr...
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| Published in: | Cardiovascular diabetology Vol. 14; no. 1; p. 116 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
BioMed Central
04.09.2015
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| ISSN: | 1475-2840, 1475-2840 |
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| Abstract | Objective
The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study.
Research design and methods
Patients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated.
Results
Over 36 months, twice-daily exenatide was associated with improved body weight (−3.9 kg), waist circumference (−3.6 cm), systolic/diastolic BP (−2.5/−2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (−0.2 mmol/L), and hsCRP (−1.7 mg/L). Heart rate did not increase (−0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight (
P
< 0.0001), waist circumference (
P
< 0.001), systolic BP (
P
< 0.001), diastolic BP (
P
= 0.023), HDL-cholesterol (
P
= 0.001), and hsCRP (
P
= 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4 %;
P
= 0.026) or lipid-lowering medication (8.4 vs 12.8 %;
P
= 0.025).
Conclusions
Add-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride.
Clinical trial registration: NCT00359762,
http://www.ClinicalTrials.gov |
|---|---|
| AbstractList | The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study.OBJECTIVEThe risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study.Patients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated.RESEARCH DESIGN AND METHODSPatients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated.Over 36 months, twice-daily exenatide was associated with improved body weight (-3.9 kg), waist circumference (-3.6 cm), systolic/diastolic BP (-2.5/-2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (-0.2 mmol/L), and hsCRP (-1.7 mg/L). Heart rate did not increase (-0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight (P < 0.0001), waist circumference (P < 0.001), systolic BP (P < 0.001), diastolic BP (P = 0.023), HDL-cholesterol (P = 0.001), and hsCRP (P = 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4%; P = 0.026) or lipid-lowering medication (8.4 vs 12.8%; P = 0.025).RESULTSOver 36 months, twice-daily exenatide was associated with improved body weight (-3.9 kg), waist circumference (-3.6 cm), systolic/diastolic BP (-2.5/-2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (-0.2 mmol/L), and hsCRP (-1.7 mg/L). Heart rate did not increase (-0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight (P < 0.0001), waist circumference (P < 0.001), systolic BP (P < 0.001), diastolic BP (P = 0.023), HDL-cholesterol (P = 0.001), and hsCRP (P = 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4%; P = 0.026) or lipid-lowering medication (8.4 vs 12.8%; P = 0.025).Add-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride.CONCLUSIONSAdd-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride.NCT00359762, http://www.ClinicalTrials.gov.CLINICAL TRIAL REGISTRATIONNCT00359762, http://www.ClinicalTrials.gov. The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study. Patients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated. Over 36 months, twice-daily exenatide was associated with improved body weight (-3.9 kg), waist circumference (-3.6 cm), systolic/diastolic BP (-2.5/-2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (-0.2 mmol/L), and hsCRP (-1.7 mg/L). Heart rate did not increase (-0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight (P < 0.0001), waist circumference (P < 0.001), systolic BP (P < 0.001), diastolic BP (P = 0.023), HDL-cholesterol (P = 0.001), and hsCRP (P = 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4%; P = 0.026) or lipid-lowering medication (8.4 vs 12.8%; P = 0.025). Add-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride. NCT00359762, http://www.ClinicalTrials.gov. Objective The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study. Research design and methods Patients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated. Results Over 36 months, twice-daily exenatide was associated with improved body weight (−3.9 kg), waist circumference (−3.6 cm), systolic/diastolic BP (−2.5/−2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (−0.2 mmol/L), and hsCRP (−1.7 mg/L). Heart rate did not increase (−0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight ( P < 0.0001), waist circumference ( P < 0.001), systolic BP ( P < 0.001), diastolic BP ( P = 0.023), HDL-cholesterol ( P = 0.001), and hsCRP ( P = 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4 %; P = 0.026) or lipid-lowering medication (8.4 vs 12.8 %; P = 0.025). Conclusions Add-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride. Clinical trial registration: NCT00359762, http://www.ClinicalTrials.gov |
| ArticleNumber | 116 |
| Author | Gallwitz, Baptist Rosas-Guzmàn, Juan Kiljański, Jacek Festa, Andreas Dotta, Francesco Zhou, Ming Guerci, Bruno Schernthaner, Guntram Simó, Rafael |
| Author_xml | – sequence: 1 givenname: Rafael surname: Simó fullname: Simó, Rafael email: rafael.simo@vhir.org organization: CIREDEM, Carlos III Health Institute, Diabetes Research and Metabolism Unit, Institut de Recerca Hospital Universitari Vall d’Hebron – sequence: 2 givenname: Bruno surname: Guerci fullname: Guerci, Bruno organization: Diabetologie, Maladies Metaboliques and Nutrition, Hôpital Brabois, CHU de Nancy, et CIC Inserm – sequence: 3 givenname: Guntram surname: Schernthaner fullname: Schernthaner, Guntram organization: Rudolfstiftung Hospital-Vienna – sequence: 4 givenname: Baptist surname: Gallwitz fullname: Gallwitz, Baptist organization: Medizinische Klinik IV, Universitätsklinikum Tübingen – sequence: 5 givenname: Juan surname: Rosas-Guzmàn fullname: Rosas-Guzmàn, Juan organization: Celaya Center for Specialist Medicine – sequence: 6 givenname: Francesco surname: Dotta fullname: Dotta, Francesco organization: Diabetes Unit, Policlinico Le Scotte, University of Siena – sequence: 7 givenname: Andreas surname: Festa fullname: Festa, Andreas organization: Eli Lilly and Company, Eli Lilly Regional Operations Ges.m.b.H – sequence: 8 givenname: Ming surname: Zhou fullname: Zhou, Ming organization: Bristol-Myers Squibb – sequence: 9 givenname: Jacek surname: Kiljański fullname: Kiljański, Jacek organization: Eli Lilly, Eli Lilly and Company, Eli Lilly Polska Sp. z o.o |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26338040$$D View this record in MEDLINE/PubMed |
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| Keywords | Type 2 diabetes Exenatide twice daily High-sensitivity C-reactive protein GLP-1 receptor agonist Cardiovascular risk |
| Language | English |
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The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether... The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether... |
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| SubjectTerms | Aged Angiology Biomarkers - blood Blood Glucose - drug effects Blood Glucose - metabolism Blood Pressure - drug effects C-Reactive Protein - metabolism Cardiology Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Cardiovascular Diseases - etiology Cardiovascular Diseases - physiopathology Cardiovascular Diseases - prevention & control Diabetes Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - physiopathology Drug Administration Schedule Drug Therapy, Combination Europe Exenatide Female Glycated Hemoglobin - metabolism Heart Rate - drug effects Humans Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - adverse effects Incretins - administration & dosage Incretins - adverse effects Lipids - blood Male Medicine Medicine & Public Health Metformin - administration & dosage Middle Aged Original Investigation Peptides - administration & dosage Peptides - adverse effects Risk Factors Sulfonylurea Compounds - administration & dosage Sulfonylurea Compounds - adverse effects Time Factors Treatment Outcome Venoms - administration & dosage Venoms - adverse effects |
| Title | Long-term changes in cardiovascular risk markers during administration of exenatide twice daily or glimepiride: results from the European exenatide study |
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