Diabetes Research Centre, University of Leicester, Leicester, UK.
Weill-Cornell Medical Center, New York, New York.
Diabetes Obes Metab. 2018 Mar;20(3):734-739. doi: 10.1111/dom.13125. Epub 2017 Nov 1.
The cardiovascular safety of liraglutide, a glucagon-like peptide-1 receptor agonist approved for weight management at a dose of 3.0 mg, was evaluated post hoc using data from 5908 participants in 5 randomized, double-blind, placebo-controlled clinical trials. Participants were randomized to liraglutide or a comparator group (placebo or orlistat). The objective was to evaluate whether cardiovascular risk was increased with liraglutide treatment. The primary composite outcome of this time-to-event analysis was the first occurrence of cardiovascular death, nonfatal myocardial infarction or nonfatal stroke. These cardiovascular events were adjudicated prospectively for three of the trials and retrospectively for two trials by an event adjudication committee. The primary outcome was analyzed using a Cox proportional hazards model, stratified by trial. With liraglutide 3.0 mg, 8 participants had positively adjudicated cardiovascular events (1.54 events/1000 person-years) compared to 10 participants in the comparators group (3.65 events/1000 person-years). The hazard ratio for liraglutide 3.0 mg compared to comparators was 0.42 (95% confidence interval, 0.17-1.08). In this analysis, liraglutide 3.0 mg treatment was not associated with excess cardiovascular risk. However, the wide confidence intervals and retrospective adjudication of events in two of the trials are limitations of the analysis.
利拉鲁肽的心血管安全性评估,一种胰高血糖素样肽-1 受体激动剂,在 3.0mg 剂量下被批准用于体重管理,使用来自 5908 名参与者的 5 项随机、双盲、安慰剂对照临床试验的数据进行事后评估。参与者被随机分配到利拉鲁肽或比较组(安慰剂或奥利司他)。目的是评估利拉鲁肽治疗是否会增加心血管风险。这项时间事件分析的主要复合终点是首次发生心血管死亡、非致死性心肌梗死或非致死性卒中。这三个试验前瞻性地对这些心血管事件进行了裁决,而另外两个试验由事件裁决委员会进行了回顾性裁决。主要结局使用 Cox 比例风险模型,按试验分层进行分析。在利拉鲁肽 3.0mg 组中,有 8 名参与者发生了阳性裁决的心血管事件(1.54 例/1000 人年),而比较组中有 10 名参与者(3.65 例/1000 人年)。与比较组相比,利拉鲁肽 3.0mg 的危险比为 0.42(95%置信区间,0.17-1.08)。在这项分析中,利拉鲁肽 3.0mg 治疗与心血管风险增加无关。然而,两个试验中的事件回顾性裁决和广泛的置信区间是分析的局限性。