Long-term changes in cardiovascular risk markers during administration of exenatide twice daily or glimepiride: results from the European exenatide study

Cardiovascular Diabetology

Jacek Kiljański²  Ming Zhou⁴  Andreas Festa³  Francesco Dotta⁶  Juan Rosas-Guzmàn⁹  Baptist Gallwitz⁷  Guntram Schernthaner⁵  Bruno Guerci⁸  Rafael Simó¹ 

[1] Diabetes Research and Metabolism Unit, Institut de Recerca Hospital Universitari Vall d’Hebron, Barcelona, Spain;Eli Lilly, Eli Lilly and Company, Eli Lilly Polska Sp. z o.o., Warsaw, Poland;Eli Lilly and Company, Eli Lilly Regional Operations Ges.m.b.H., Vienna, Austria;Bristol-Myers Squibb, Pennington, NJ, USA;Rudolfstiftung Hospital-Vienna, Vienna, Austria;Diabetes Unit, Policlinico Le Scotte, University of Siena, Siena, Italy;Medizinische Klinik IV, Universitätsklinikum Tübingen, Tübingen, Germany;Diabetologie, Maladies Metaboliques and Nutrition, Hôpital Brabois, CHU de Nancy, et CIC Inserm, Vandoeuvre Lès Nancy, France;Celaya Center for Specialist Medicine, Celaya, Guanajuato, Mexico

关键词: High-sensitivity C-reactive protein;    Cardiovascular risk;    Exenatide twice daily;    GLP-1 receptor agonist;    Type 2 diabetes;   

Others  :  1223745
DOI  :  10.1186/s12933-015-0279-z

 received in 2015-05-20, accepted in 2015-08-13,  发布年份 2015

【 摘 要 】

Objective

The risk of cardiovascular morbidity and mortality is significantly increased in patients with diabetes; thus, it is important to determine whether glucose-lowering therapy affects this risk over time. Changes in cardiovascular risk markers were examined in patients with type 2 diabetes treated with exenatide twice daily (a glucagon-like peptide-1 receptor agonist) or glimepiride (a sulfonylurea) added to metformin in the EURopean EXenAtide (EUREXA) study.

Research design and methods

Patients with type 2 diabetes failing metformin were randomized to add-on exenatide twice daily (n = 515) or glimepiride (n = 514) until treatment failure defined by hemoglobin A1C. Anthropomorphic measures, blood pressure (BP), heart rate, lipids, and high-sensitivity C-reactive protein (hsCRP) over time were evaluated.

Results

Over 36 months, twice-daily exenatide was associated with improved body weight (−3.9 kg), waist circumference (−3.6 cm), systolic/diastolic BP (−2.5/−2.6 mmHg), high-density lipoprotein (HDL)-cholesterol (0.05 mmol/L), triglycerides (−0.2 mmol/L), and hsCRP (−1.7 mg/L). Heart rate did not increase (−0.3 beats/minute), and low-density lipoprotein-cholesterol (0.2 mmol/L) and total cholesterol (0.1 mmol/L) increased slightly. Between-group differences were significantly in favor of exenatide for body weight (P < 0.0001), waist circumference (P < 0.001), systolic BP (P < 0.001), diastolic BP (P = 0.023), HDL-cholesterol (P = 0.001), and hsCRP (P = 0.004). Fewer patients randomized to exenatide twice daily versus glimepiride required the addition of at least one antihypertensive (20.4 vs 26.4 %; P = 0.026) or lipid-lowering medication (8.4 vs 12.8 %; P = 0.025).

Conclusions

Add-on exenatide twice daily was associated with significant, sustained improvement in several cardiovascular risk markers in patients with type 2 diabetes versus glimepiride.

Clinical trial registration: NCT00359762, http://www.ClinicalTrials.gov

【 授权许可】

   
2015 Simó et al.

【 图 表 】

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