GLP-1 drugs linked to long-term benefits for PAD patients
GLP-1 drugs are associated with multiple benefits for patients with peripheral artery disease (PAD) and type 2 diabetes, according to new findings published in the Journal of the American Heart Association.[1]
“Individuals with PAD have significant risk of both cardiovascular and limb outcomes, which are exaggerated in patients with type 2 diabetes,” wrote Akiva Rosenzveig, MD, a researcher with the Heart, Vascular & Thoracic Institute at Cleveland Clinic, and colleagues. “Prior large‐scale observational studies … have shown that patients with atherothrombosis, including those with PAD, experience annual cardiovascular event rates of 4% to 5% and cumulative risks approaching 17% to 20% at 4 years, despite standard therapy. These data highlight the urgent need for more effective strategies to reduce both cardiovascular and limb events in this high‐risk population.”
Rosenzveig et al. used propensity score matching to focus on data from two groups of more than 2,100 adult patients with PAD and type 2 diabetes. All data came from the TriNetX platform. Patients were excluded if they had a history of acute myocardial infarction, stroke or end-stage renal disease within 2 months prior to the index ambulatory event. Patients started treatment with either a GLP-1 receptor agonist or metformin.
Overall, after five years, patients treated with GLP-1 therapy were linked to significantly lower rates of mortality (10.3% vs. 0.7%), hospitalization (69.3% vs. 74.7%), revascularization (4.7% vs. 7.3%), major amputation (2.3% vs. 4.4%) and minor amputation (4% vs. 6.4%) than patients treated with metformin. The rates of myocardial infarction, stroke, major adverse cardiovascular events and major adverse kidney events (MAKEs) were similar for the two treatment groups.
Rosenzveig and colleagues also performed a subanalysis on two groups of 465 patients who presented with claudication. Again, GLP-1 drugs were linked to significant benefits over metformin, including lower rates of all-cause mortality, hospitalizations and major amputations. Yet another subanalysis was performed on two groups of nearly 2,400 patients with chronic limb threatening ischemia (CLTI). Among those patients, GLP-1 drugs were linked to lower rates of mortality, hospitalization, revascularization, major amputations and minor amputations. The MAKE risk, meanwhile, was slightly higher for patients presenting with CLTI.
“Our findings strongly suggest that GLP‐1 RAs should be prioritized in the management of PAD, particularly in patients with coexisting type 2 diabetes,” the authors concluded.
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GLP-1 drugs continue to be one of healthcare’s biggest stories
The rise of semaglutide and other GLP-1 medications is one of modern medicine’s biggest trends. These drugs were originally developed to treat diabetes, but they have been linked to substantial weight loss for a wide variety of patient populations. Different GLP-1 drugs have also been associated with certain cardiovascular benefits, helping them grow more and more popular among cardiologists and other clinicians who see high-risk heart patients on a daily basis. Both injectable and oral GLP-1 drugs have received U.S. Food and Drug Administration approval, and work on an implant is now underway.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.