In a nutshell
This study assessed the effect of dulaglutide (Trulicity) on heart disease risk in patients with type 2 diabetes (T2D). The authors concluded that dulaglutide is an optimal treatment for patients with T2D at risk of heart disease.
While measures are put in place to protect heart health, diabetes increases the risk of cardiac events (e.g. heart attack or stroke) and death by 1.5-2 times. As glucose-lowering drugs are a mainstay treatment in diabetes it is important to know whether they contribute to this risk. Dulaglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist. A class of drugs used to treat T2D. There has been evidence that other drugs in this class may reduce heart risk. Therefore, it was helpful to determine whether dulaglutide had the same effect in patients with T2D.
Methods & findings
This study included 9901 patients over the age of 50 with T2D. These patients had a history or risk factors for heart diseases such as high blood pressure or high blood fat levels. Patients were divided into two groups. One group received dulaglutide injections. The other group received a placebo. Patients were followed up for an average of 5.4 years.
During follow-up, a cardiac event (stroke, heart attack, or death from heart disease) primary outcome occurred in 12% of the dulaglutide group and in 13.4% of the placebo group. The risk of having a cardiac event was 12% lower in patients treated with dulaglutide. The all-cause mortality (mortality from any cause) was similar in both groups.
Side effects related to the digestive system were reported in 47.3% of the dulaglutide group. This was compared to 34.1% in the placebo group. 9.1% of patients stopped the study drug due to side effects, this number was 6.3% in the placebo group.
At the beginning of the study, both groups had similar use of other medications. However, by the end of the study fewer people in the dulaglutide group were taking other diabetes and blood pressure medications. Those in the dulaglutide group also had lower HbA1c values, lower body weight, and lower blood pressure. HbA1c is a measurement of average blood glucose levels over the past 3 months.
The bottom line
The authors concluded that dulaglutide is an optimal treatment for patients with T2D and a previous cardiac event or cardiac risk factors.
The fine print
This study was funded by Eli Lilly and Company, the manufacturer of dulaglutide.
Published By :
Lancet (London, England)
Original Title :
Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.
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