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What Are We Learning from the FDA-Mandated Cardiovascular Outcome Studies for New Pharmacological Antidiabetic Agents?

  • Pharmacologic Treatment of Type 2 Diabetes (HE Lebovitz and G Bahtiyar, Section Editors)
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Abstract

Cardiovascular disease (CVD) is common in patients with diabetes. For these patients, clinicians should seek diabetes treatment that is beneficial rather than harmful in relation to CVD. Until recently, there have been many treatments for hyperglycemia, whose impact on CVD has been controversial. The aims of this review are to evaluate the effectiveness of antihyperglycemic medications on risk factors for CVD and to examine the impact of these drugs on CVD in cardiovascular (CV) outcome trials. In this article, we summarize current knowledge about the impacts of these drugs on various risk factors as well as CV outcomes. We identify the recent emergence of trials with antihyperglycemic agents showing newly discovered CV benefits as well as past trials with antihyperglycemic agents not showing much benefit on CV events. Rather than focusing on treatment strategies, we review the effects of individual drug classes on CV outcomes. We also briefly review goal-driven glycemia reduction and its impact on CVD. We conclude that antihyperglycemic agents are associated with improvement in CV risk factors in patients with diabetes and insulin resistance; in fact, a few drugs reduced CV events in randomized CV outcome trials. Therefore, the use of these drugs is appropriate for reducing glucose and decreasing CV event risk in a select subpopulation.

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Acknowledgments

Dr. Fonseca is supported in part by the Tullis Tulane Alumni Chair in Diabetes, the Patient Centered Outcomes Research Institute (through LACDRN), and grant 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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All authors contributed to the literature search and writing of the manuscript. V.F. designed the search strategy, supervised study implementation, and reviewed/edited the manuscript.

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  1. Tulane University Health Sciences Center, 1430 Tulane Ave., SL-53, New Orleans, LA, 70112, USA

    Dragana Lovre, Wynn Htun, Carly Carrion & Vivian A. Fonseca

  2. Southeast Louisiana Veterans Health Care Systems, New Orleans, USA

    Vivian A. Fonseca

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  1. Dragana Lovre
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Correspondence to Dragana Lovre.

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Conflict of Interest

Vivian A. Fonseca reports grants from Eli Lilly, Abbott, Mesoblast, Asahi, Bristol-Myers Squibb, Gilead. He reports others from Takeda, Sanofi-Aventis, Intarcia, and Novo Nordisk. He reports personal fees from Intarcia, Merck, GlaxoSmithKline, Sanofi-Aventis, Eli Lilly, Astra-Zeneca, Pan American Laboratories, Takeda, Jansen, Boehringer Ingelheim, and NuMe Health/Microbiome.

Dragana Lovre, Wynn Htun, and Carly Carrion declare that they have no conflict of interest.

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This article is part of the Topical Collection on Pharmacologic Treatment of Type 2 Diabetes

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Lovre, D., Htun, W., Carrion, C. et al. What Are We Learning from the FDA-Mandated Cardiovascular Outcome Studies for New Pharmacological Antidiabetic Agents?. Curr Diab Rep 16, 94 (2016). https://doi.org/10.1007/s11892-016-0788-5

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