Forschergruppe Diabetes e. V., Ingolstaedter Landstraße 1, Neuherberg, 85764, Munich, Germany.
Cardiology Unit, Department of Medicine K2, Karolinska Institute, 171 76, Stockholm, Sweden.
Cardiovasc Diabetol. 2017 Oct 11;16(1):128. doi: 10.1186/s12933-017-0610-y.
In 2008 the Food and Drug Administration introduced a guidance for industry that requires the investigation of cardiovascular outcomes of glucose-lowering medications. Since then, an increasing number of cardiovascular outcome trials have been completed in diabetes patients with high cardiovascular risk for members of the SGLT-2 and DPP4 inhibitors and GLP-1 receptor agonist classes. The trials confirmed cardiovascular safety for all tested anti-hyperglycaemic drugs and, in addition empagliflozin, semaglutide and liraglutide could even reduce cardiovascular risk. The present review summarizes the results of the DEVOTE, CANVAS, EXSCEL and ACE trials that tested cardiovascular safety of Insulin degludec, canagliflozin, once-weekly exenatide and acarbose and were published in 2017. We provide context on these results by comparing them with earlier trials of glucose-lowering drugs and give an outlook on what to expect in coming years.
2008 年，食品和药物管理局发布了一项行业指南，要求调查降低血糖药物的心血管结局。此后，越来越多的心血管结局试验已经完成，涉及高心血管风险的糖尿病患者，这些患者使用 SGLT-2 和 DPP4 抑制剂以及 GLP-1 受体激动剂类药物。这些试验证实了所有测试的抗高血糖药物的心血管安全性，此外，恩格列净、司美格鲁肽和利拉鲁肽甚至可以降低心血管风险。本综述总结了 2017 年发表的 DEVOTE、CANVAS、EXSCEL 和 ACE 试验的结果，这些试验测试了胰岛素德谷胰岛素、卡格列净、每周一次的艾塞那肽和阿卡波糖的心血管安全性。我们通过将这些结果与早期的降糖药物试验进行比较，为这些结果提供了背景，并展望了未来几年的情况。
