Elnour Asim Ahmed, Al Hajri Noora, El Khidir Israa Yousif, AlAmoodi Abdulla, Ahmed Sahar Asim, Sadeq Adel
College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates.
Department of Epidemiology and Population Health, Khalifa University, Abu Dhabi, United Arab Emirates.
Curr Diabetes Rev. 2020;16(8):820-832. doi: 10.2174/1573399816666200522214554.
We thought to delve deeper into seven meta-analyses of major clinical trials focusing on Glucagon-Like Peptide-One Receptor Agonist (GLP-1 RA) cardioprotective effect.
We explored the role of GLP-1 RA in cardiovascular risk protection as the primary outcome in subjects with type 2 diabetes mellitus.
The current review has explored and critically appraised seven meta-analyses of placebo- controlled randomized clinical trials (RCT-s) involving GLP-1 RA used in diabetes that has exhibited major cardiovascular events as the primary outcome.
Based on the participants-intervention-comparison and outcomes (PICO), the total number of the participants in this review were (138750), the intervention was conducted with GLP-1 RA, the comparator was a placebo and the outcome was major cardiovascular events. The overall evidence for the cardioprotective effect of GLP-1 RA in diabetes was very clear in subjects with the cardiovascular risk of varying degrees. Most of the currently reviewed meta-analyses have not shown cardioprotection with GLP-1 RA in subjects with diabetes exhibiting high cardiovascular risk or medical history of cardiovascular diseases. Patient variability, in addition to potency parameters, will be the key to a successful member of the class. There will be avenues for selection of a candidate based on the suitability to patient preferences and characteristics.
The RCT-s for GLP-1 RA should characterize cardiovascular risk in subjects with diabetes such that disparities between established cardiovascular risk (high, moderate and low) or medical history of cardiovascular disease have been accounted for in subgroup analysis.
我们试图更深入地研究七项主要临床试验的荟萃分析，这些试验聚焦于胰高血糖素样肽-1受体激动剂（GLP-1 RA）的心脏保护作用。
我们探讨了GLP-1 RA在2型糖尿病患者心血管风险保护中的作用，并将其作为主要结局。
本综述对七项安慰剂对照随机临床试验（RCT）的荟萃分析进行了探索和批判性评估，这些试验涉及用于糖尿病的GLP-1 RA，并将主要心血管事件作为主要结局。
基于参与者-干预-对照和结局（PICO），本综述中的参与者总数为138750，干预措施为使用GLP-1 RA，对照为安慰剂，结局为主要心血管事件。GLP-1 RA对糖尿病患者的心脏保护作用的总体证据在不同程度心血管风险的受试者中非常明确。目前审查的大多数荟萃分析并未显示GLP-1 RA对具有高心血管风险或心血管疾病病史的糖尿病患者具有心脏保护作用。除效能参数外，患者变异性将是该类药物成功应用的关键。将有基于患者偏好和特征的适用性来选择候选药物的途径。
GLP-1 RA的RCT应明确糖尿病患者的心血管风险，以便在亚组分析中考虑已确定的心血管风险（高、中、低）或心血管疾病病史之间的差异。
