Results have been presented at the European Society of Cardiology (ESC) Congress 2024 of a meta-analysis that studied the cardiovascular outcomes of glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with obesity without diabetes mellitus. The effects of GLP-1RAs on cardiovascular outcomes in patients with diabetes mellitus have been studied extensively, but their cardioprotective effects in patients with obesity are yet to be substantiated.
19 randomised controlled trials (RCTs) were retrieved from PubMed, Cochrane, SCOPUS and Web of Science up to 26 December 2023, gathering data on 32,884 patients to synthesise systematic review and meta-analysis, which was conducted using StataMP 17. Cardiovascular outcomes, which include changes in symptoms relating to heart failure and death from cardiovascular causes, were the primary outcome of the study.
In results on efficacy and safety presented by Mohamed Abouzid of Poznan University of Medical Sciences, Poland, on Sunday 1 September, while cardiovascular mortality was the same among patients who received GLP-1RAs and those who received placebo (RR:0.85, 95% CI [0.71- 1.01], P= 0.07), the incidence of all-cause mortality (RR 0.83, 95% CI 0.72 to 0.94, p < 0.0001), non-cardiovascular mortality (RR 0.78, 95% CI 0.63 to 0.96, p = 0.02), and myocardial infarction (MI) (RR 0.73, 95% CI 0.62 to 0.87, p < 0.0001) was significantly decreased by the use of GLP-1RAs. However, the incidence of adverse events, but not of serious adverse events, increased significantly with GLP-1RAs (RR 1.11, 95% CI 1.05 to 1.16, p < 0.0001).
The study demonstrates GLP-1RAs’ significant benefits in lowering cardiovascular risks, namely reducing all-cause mortality and risk of MI while also promoting weight loss, bettering lipid profiles and enhancing blood pressure control. Nonetheless, GLP-1RAs are generally associated with an increased incidence of gastrointestinal side effects and heterogeneity in outcomes, underscoring the importance of personalised treatment approaches.
Key opinion leaders (KOLs) interviewed by GlobalData have stated that “you [have] got to make sure that you show that you are not just improving the weight of the patients, but you are improving the health of the patients [too]. So, you do have to look at the diabetes, and hypertension, and lipids… and you do have to [also] look at the cardiovascular disease outcome.”
According to GlobalData’s Pharma Intelligence Center, there are 20 Phase III candidates, 59 Phase II candidates, and 96 Phase I candidates for obesity globally.
