GLP1-receptor agonists – antidiabetic drugs with cardiovascular benefit
1Bajcsy-Zsilinszky Kórház és Rendelőintézet, Budapest
Dr. Jermendy György, 1106 Budapest, Maglódi út 89–91.
GLP1-receptor agonists should be considered as relatively new antihyperglycemic agents for treating patients with type 2 diabetes. They can be used subcutaneously, while the first oral derivative agent (semaglutid tablet) will be available soon in 2020. GLP1-receptor agonists proved to be safe in cardiovascular trials, however, cardiovascular benefits were also observed in certain trials. In this article, results of randomized, controlled cardiovascular trials with GLP1-receptor agonists published between 2015 and 2019 are reviewed. No effect differences were observed between patients with cardiovascular risk factors only and those with established cardiovascular diseases in five trials with cardiovascular benefit. This result strengthens the view that stratifying cardiovascular risk rather than making a distinction between primary and secondary prevention should be considered more appropriate when considering the initiation of antihyperglycemic therapy with GLP1-receptor agonists in patients with type 2 diabetes. The results of cardiovascular trials with GLP1-receptor agonists provided substantial arguments for considering cardiovascular risks at treatment initiation or combination. Several guidelines were updated in 2019 underlying the importance of using antidiabetic drugs with proven cardiovascular benefit in patients with type 2 diabetes and high or very high cardiovascular risk. For this reason, diabetologists and cardiologists should work in close collaboration.