Physicians' Academy for Cardiovascular Education

Treatment benefit of GLP-1RA in elderly with T2DM may vary with age

Effect of Liraglutide on Cardiovascular Outcomes in Elderly Patients: A Post Hoc Analysis of a Randomized Controlled Trial

Literature - Gilbert MP, Bain SC, Franek E et al., - Ann Intern Med. 2018. DOI: 10.7326/M18-1569

Introduction and methods

Comorbidities and complications associated with type 2 diabetes (T2DM) increase with age. Because this challenges treatment of elderly people with T2DM, the US Food and Drug Administration and European Medicines Agency recommend collecting comprehensive data on this patient group, to inform appropriate treatment of this growing group [1,2].

GLP-1 receptor agonists (GLP-1RA) have been demonstrated to give high glycemic efficacy and low intrinsic risk for hypoglycemia, and they also promote weight loss [3]. In the LEADER trial, the GLP-1RA liraglutide was shown to yield a 13% reduction in major adverse cardiovascular events (MACE), as compared with placebo, in patients with T2DM at high risk for CV events [4].

This posthoc analysis examined the CV effects of liraglutide vs. placebo in patients aged 75 years or older (n=836), and in those aged 60 to 74 years with risk factors for CV disease (n=6183). A secondary outcome was expanded MACE, defined as MACE or coronary revascularization, hospitalization for unstable angina pectoris or heart failure, all-cause death or non-CV death.

Main results

Treatment benefit of GLP-1RA in elderly with T2DM may vary with age


This post-hoc analysis of the LEADER trial showed that liraglutide significantly reduced the risk for MACE, expanded MACE and all-cause death in elderly patients at high risk for CV events, compared with placebo. The treatment benefit was more pronounced in patients older than 75 years, as compared to those aged 60 to 74 years.


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