GLP-1 receptorové agonisty sú novými antidiabetikami a nie je preskúmaný ich vplyv u diabetikov s prejavmi srdcového zlyhávania (SZ). K zodpovedaniu ich účinku u chorých so SZ poslúžila osobitná analýza štúdie LEADER. V nej bola podskupi-na diabetikov s prejavmi SZ v triedach NYHA I, II a III (1 667 pacientov, 18 %) a v celej štúdii bolo 9 340 diabetikov s vysokým kardiovaskulárnym rizikom randomizovaných k liečbe liraglutidom 1,8 mg alebo k liečbe placebom pri ostatnej štandardnej antidiabetickej liečbe.Výskyt veľkých kardiovaskulárnych príhod (nefatálny infarkt myokardu, nefatálna cievna mozgová príhoda) včítane celkovej i kardiovaskulárnej mortality a hospitalizácií pre SZ bol v ramene liečby liraglutidom s relatívnym rizikom (RR) 0,81 u diabetikov s prejavmi SZ a bol 0,88 u diabetikov bez SZ, výskyt úmrtí bol s RR 0,89 (diabetici so SZ) versus s RR 0,83 (diabetici bez SZ), výskyt hospitalizácií pre SZ bol s RR 0,98 (diabetici so SZ) versus s RR 0,78 (diabetici bez SZ).Liraglutid možno bezpečne podávať diabetikom 2. typu aj v prípade, ak trpia prejavmi SZ. Nie je to však antidiabetikum indi-kované k liečbe SZ u diabetikov.

GLP-1 receptor agonists are a new class of antidiabetic drugs and there are no data about their effects in heart failure (HF) pa-tients. This problem was investigated in an analysis of LEADER study. This study randomized 9 340 type 2 diabetic patients (1 667 patients, 18% of them with HF symptoms in NYHA classes I,II,III) with high cardiovascular risk into treatment with liraglutide (1.8 mg daily) or with placebo, all patients otherwise with standard antidiabetic treatment.The occurence of major adverse cardiovascular events (nonfatal myocardial infarction and stroke, cardiovascular and all-cause mortality and HF hospitalizations) was nonsingificantly reduced in the liraglutide treatment arm with relative risk (RR) reduction of 0.81 (diabetic patients with HF) versus of RR 0.88 (diabetic patients without HF), the occurence of mortality was with RR 0.89 (diabetic patients with HF) versus with RR 0.83 (diabetic patients without HF) and the occurence of HF hospitalizations with RR 0.98 (diabetic patients with HF ) versus RR 0 78 (diabetic patients without HF ).Liraglutide can be safely given to type 2 diabetic patients with HF symptoms. It is just not the treatment for HF in diabetic patients.

1 interná klinika LFUK a UN Bratislava

Ústav farmakológie a klinickej farmakológie LFUK Bratislava

Liraglutid in diabetic patients in LEADER study - is there any benefit in patients with heart failure?

Citace poskytuje Crossref.org

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