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

Simó R, Guerci B, Schernthaner G, Gallwitz B, Rosas-Guzmàn J, Dotta F, Festa A, Zhou M, Kiljański J - Cardiovasc Diabetol (2015)

Bottom Line: 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).

View Article: PubMed Central - PubMed

Affiliation: CIREDEM, Carlos III Health Institute, Barcelona, Spain. rafael.simo@vhir.org.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

LS mean (SE) change from baseline (left panel) and treatment difference (right panel, exenatide twice daily − glimepiride) in body weight (a) and waist circumference (b) in randomized patients. BID twice daily, LS least-squares, SE standard error
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Fig1: LS mean (SE) change from baseline (left panel) and treatment difference (right panel, exenatide twice daily − glimepiride) in body weight (a) and waist circumference (b) in randomized patients. BID twice daily, LS least-squares, SE standard error

Mentions: Body weight decreased from baseline in theexenatide twice-daily group and increased in the glimepiride group at 36 months (Table 2; Fig. 1a). The between-group difference in the change from baseline was significantly in favor of exenatide twice daily at each visit from 6 to 36 months (P < 0.0001). Analysis by sex showed similar trends between males and females for body weight change and between-group differences. Significant between-group differences in favor of exenatide twice daily were observed in both males [LS mean (standard error [SE]), −5.3 (0.63) kg; P < 0.0001] and females [−5.2 (0.68) kg; P < 0.0001].Table 2


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

Simó R, Guerci B, Schernthaner G, Gallwitz B, Rosas-Guzmàn J, Dotta F, Festa A, Zhou M, Kiljański J - Cardiovasc Diabetol (2015)

LS mean (SE) change from baseline (left panel) and treatment difference (right panel, exenatide twice daily − glimepiride) in body weight (a) and waist circumference (b) in randomized patients. BID twice daily, LS least-squares, SE standard error
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4558893&req=5

Fig1: LS mean (SE) change from baseline (left panel) and treatment difference (right panel, exenatide twice daily − glimepiride) in body weight (a) and waist circumference (b) in randomized patients. BID twice daily, LS least-squares, SE standard error
Mentions: Body weight decreased from baseline in theexenatide twice-daily group and increased in the glimepiride group at 36 months (Table 2; Fig. 1a). The between-group difference in the change from baseline was significantly in favor of exenatide twice daily at each visit from 6 to 36 months (P < 0.0001). Analysis by sex showed similar trends between males and females for body weight change and between-group differences. Significant between-group differences in favor of exenatide twice daily were observed in both males [LS mean (standard error [SE]), −5.3 (0.63) kg; P < 0.0001] and females [−5.2 (0.68) kg; P < 0.0001].Table 2

Bottom Line: 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).

View Article: PubMed Central - PubMed

Affiliation: CIREDEM, Carlos III Health Institute, Barcelona, Spain. rafael.simo@vhir.org.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus