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*Only for reference by medical professionals.
After the ups and downs of the "sugar" sea, I am still full of expectations.
10 years, say that long is not long, and that short is not short.
For endocrinologists and diabetic patients, the past 10 years have been truly "earth-shaking".
The treatment concept of type 2 diabetes (T2DM) has undergone tremendous changes: from emphasizing the individualization of hypoglycemic goals 10 years ago, to focusing on the control of cardiovascular disease risk factors, to emphasizing the comprehensive management of cardiovascular outcomes [1-3] .
With the accumulation of evidence of cardiovascular benefits of new blood sugar lowering drugs, patients with T2DM have a choice of drugs that can reduce blood sugar and have comprehensive benefits.
Liraglutide in the glucagon-like peptide-1 receptor agonist (GLP-1RA) class of drugs is one of the new hypoglycemic drugs that can bring cardiovascular benefits to patients.
It entered the Chinese market 10 years ago.
Promoted and witnessed the ups and downs of the "sugar" sea over the years.
Deli Control Sugar Helper Helps Chinese Diabetes Patients to Meet the Blood Sugar Standard Back in 2011.
The Chinese registration study led by Professor Yang Wenying provided the Chinese data on the efficacy and safety of liraglutide for the first time, making it a popular hit in China.
Successfully listed.
Among the 928 Asian T2DM patients included in the study, 51.
3% were Chinese patients.
The study found that after 16 weeks of treatment with liraglutide, the glycosylated hemoglobin (HbA1c) was significantly reduced.
Patients treated with liraglutide at 1.
8 mg daily HbA1c decreased by as much as 1.
45%, and it was also found that liraglutide can significantly reduce weight and the risk of hypoglycemia is extremely low, making the proportion of patients reaching the composite endpoint of HbA1c+no weight gain+no hypoglycemia better than the control group [4].
Based on this, on April 13th of the same year, liraglutide was approved in China.
Since then, the Chinese Type 2 Diabetes Prevention and Control Guidelines (referred to as the "CDS Guidelines") issued by the Diabetes Society of the Chinese Medical Association (CDS) in 2013 has also been officially released Include GLP-1RA as a third-line main treatment drug [5].In 2016, a study, LIRA-DPP-4 CHINA, conducted entirely in the Chinese population, added a strong touch to the evidence-based evidence for liraglutide in China.
This study compared the effects of liraglutide and sitagliptin on blood glucose improvement after combined with metformin treatment.
Compared with sitagliptin, liraglutide can significantly reduce the patient's HbA1c (p<0.
0001) (Figure 1), fasting blood glucose (FPG) (p<0.
0001), weight (p<0.
0001), and waist circumference (p=0.
0005).
At the same time, the proportion of patients who reached the composite endpoint of HbA1c + no weight gain + no hypoglycemia was as high as 69.
1%, which was significantly higher than 42.
3% in the sitagliptin group [6].
Figure 1.
After 26 weeks of treatment, liraglutide reduced HbA1c significantly better than sitagliptin.
With the help of evidence-based evidence, in the 2017 version of the "CDS Guidelines", GLP-1RA also leapt to the status of dual therapy[2 ].
The evidence of cardiovascular benefits is solid, and the guidelines are further changed.
In 2016, the results of the global multi-center cardiovascular outcome study (CVOT) LEADER study were announced at the annual meeting of the American Diabetes Association (ADA), which set off a wave in the endocrine field.
As a result, liraglutide became the first GLP-1RA drug to have cardiovascular (CV) benefits confirmed by CVOT, and it also opened the door to a new future in diabetes management.
The LEADER study is an international, multicenter, randomized, double-blind, placebo-controlled phase 3b clinical study with long-term follow-up.
It aims to evaluate standard treatment combined with Lira in adult T2DM patients at high risk of cardiovascular disease (CVD) Lutide or placebo in the treatment of cardiovascular events.
The study found that the use of liraglutide on the basis of standard treatment can significantly reduce the risk of major adverse cardiovascular events (MACE) by 13% (Figure 2), and significantly reduce the risk of cardiovascular death by 22% and the risk of all-cause death by 15% [ 7].
Figure 2.
The MACE risk of patients in the liraglutide group was reduced by 13%.
Since then, major domestic and foreign authoritative guidelines, including the 2017 version of the CDS guidelines, have also begun to pay attention to the cardiovascular outcome of T2DM patients with cardiovascular risk factors.
China's "Type 2 Diabetes Combinations" "Expert consensus on the application of hypoglycemic drugs in patients with atherosclerotic cardiovascular disease" has also emerged to help clinicians better provide more suitable and ideal treatments for diabetes patients with CVD [2, 8].
More evidence has emerged.
After the LEADER study of GLP-1 RA opened a new chapter in the treatment of diabetes, the cardiovascular benefits of hypoglycemic drugs have received widespread attention, and evidence of the cardiovascular benefits of other new hypoglycemic drugs has also been published[9-10], As the so-called one stone ignited a thousand waves, supported by evidence-based evidence, the status of GLP-1RA in major guidelines has risen.
The 2020 version of the "CDS Guidelines" just issued on April 19, 2021 also made a major update on the treatment path of T2DM patients [3], recommending the diagnosis of atherosclerotic cardiovascular disease (ASCVD) or high-risk factors, chronic kidney disease For T2DM patients with CKD, it is recommended to combine GLP-1RA and other blood glucose lowering drugs with cardiovascular benefits on the basis of life>
For patients without ASCVD or high-risk factors, heart failure, or CKD, GLP-1RA is also an important treatment for dual combination therapy (Figure 3).
Figure 3.
Treatment path for hyperglycemia in T2DM patients.
On May 14, 2020, liraglutide CV indication was approved: it is suitable for reducing the major cardiovascular adverse events (cardiovascular death, non-fatal) in adult patients with T2DM with cardiovascular disease The risk of severe myocardial infarction or non-fatal stroke) provides a solid guarantee for GLP-1RA drugs in the standardized diagnosis and treatment of patients with T2DM combined with cardiovascular disease.
Summary Liraglutide has been on the market in China for ten years, and the gratifying data brought by previous research is still fresh in memory.
A number of studies have shown that liraglutide can not only effectively reduce blood sugar, but also increase the proportion of patients who reach the composite endpoint of HbA1c + no weight gain + no hypoglycemia.
It is a more clinically ideal hypoglycemic drug. The LEADER study has also revealed the cardiovascular benefits of liraglutide, making it an ideal hypoglycemic drug for diabetic patients with CVD.
The approval of the CV indication for liraglutide is a new "weapon" for Chinese endocrinologists.
It is hoped that in the future it can help Chinese T2DM patients to reduce the risk of major cardiovascular adverse events and benefit more diabetes patients with CVD! References: [1] Diabetes Branch of Chinese Medical Association.
China Type 2 Diabetes Prevention and Control Guide: 2010 Edition [M].
Peking University Medical Press, 2011.
[2] Jia Weiping, et al.
Chinese Journal of Diabetes.
2018; 10(1 ):4-67.
[3] Diabetes Branch of Chinese Medical Association.
Chinese Journal of Diabetes.
2021;13(4):315-409.
[4]Yang W, et al.
Diabetes Obes Metab.
2011;13(1) :81-8.
[5] Diabetes Branch of Chinese Medical Association.
Chinese Journal of Diabetes.
2014;6(7):447-496.
[6]Zang L, et al.
Diabetes Obes Metab.
2016;18(8): 803-11.
[7]Marso SP, et al.
N Engl J Med.
2016;375(4):311-22.
[8]Hong Tianpei, et al.
Chinese Journal of Diabetes.
2017; 25(6):481 -492.
[9]Holman RR, et al.
N Engl J Med.
2017;377(13):1228-1239.
[10]Gerstein HC, et al.
Lancet.
2019;394(10193):121-130.
For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cn
After the ups and downs of the "sugar" sea, I am still full of expectations.
10 years, say that long is not long, and that short is not short.
For endocrinologists and diabetic patients, the past 10 years have been truly "earth-shaking".
The treatment concept of type 2 diabetes (T2DM) has undergone tremendous changes: from emphasizing the individualization of hypoglycemic goals 10 years ago, to focusing on the control of cardiovascular disease risk factors, to emphasizing the comprehensive management of cardiovascular outcomes [1-3] .
With the accumulation of evidence of cardiovascular benefits of new blood sugar lowering drugs, patients with T2DM have a choice of drugs that can reduce blood sugar and have comprehensive benefits.
Liraglutide in the glucagon-like peptide-1 receptor agonist (GLP-1RA) class of drugs is one of the new hypoglycemic drugs that can bring cardiovascular benefits to patients.
It entered the Chinese market 10 years ago.
Promoted and witnessed the ups and downs of the "sugar" sea over the years.
Deli Control Sugar Helper Helps Chinese Diabetes Patients to Meet the Blood Sugar Standard Back in 2011.
The Chinese registration study led by Professor Yang Wenying provided the Chinese data on the efficacy and safety of liraglutide for the first time, making it a popular hit in China.
Successfully listed.
Among the 928 Asian T2DM patients included in the study, 51.
3% were Chinese patients.
The study found that after 16 weeks of treatment with liraglutide, the glycosylated hemoglobin (HbA1c) was significantly reduced.
Patients treated with liraglutide at 1.
8 mg daily HbA1c decreased by as much as 1.
45%, and it was also found that liraglutide can significantly reduce weight and the risk of hypoglycemia is extremely low, making the proportion of patients reaching the composite endpoint of HbA1c+no weight gain+no hypoglycemia better than the control group [4].
Based on this, on April 13th of the same year, liraglutide was approved in China.
Since then, the Chinese Type 2 Diabetes Prevention and Control Guidelines (referred to as the "CDS Guidelines") issued by the Diabetes Society of the Chinese Medical Association (CDS) in 2013 has also been officially released Include GLP-1RA as a third-line main treatment drug [5].In 2016, a study, LIRA-DPP-4 CHINA, conducted entirely in the Chinese population, added a strong touch to the evidence-based evidence for liraglutide in China.
This study compared the effects of liraglutide and sitagliptin on blood glucose improvement after combined with metformin treatment.
Compared with sitagliptin, liraglutide can significantly reduce the patient's HbA1c (p<0.
0001) (Figure 1), fasting blood glucose (FPG) (p<0.
0001), weight (p<0.
0001), and waist circumference (p=0.
0005).
At the same time, the proportion of patients who reached the composite endpoint of HbA1c + no weight gain + no hypoglycemia was as high as 69.
1%, which was significantly higher than 42.
3% in the sitagliptin group [6].
Figure 1.
After 26 weeks of treatment, liraglutide reduced HbA1c significantly better than sitagliptin.
With the help of evidence-based evidence, in the 2017 version of the "CDS Guidelines", GLP-1RA also leapt to the status of dual therapy[2 ].
The evidence of cardiovascular benefits is solid, and the guidelines are further changed.
In 2016, the results of the global multi-center cardiovascular outcome study (CVOT) LEADER study were announced at the annual meeting of the American Diabetes Association (ADA), which set off a wave in the endocrine field.
As a result, liraglutide became the first GLP-1RA drug to have cardiovascular (CV) benefits confirmed by CVOT, and it also opened the door to a new future in diabetes management.
The LEADER study is an international, multicenter, randomized, double-blind, placebo-controlled phase 3b clinical study with long-term follow-up.
It aims to evaluate standard treatment combined with Lira in adult T2DM patients at high risk of cardiovascular disease (CVD) Lutide or placebo in the treatment of cardiovascular events.
The study found that the use of liraglutide on the basis of standard treatment can significantly reduce the risk of major adverse cardiovascular events (MACE) by 13% (Figure 2), and significantly reduce the risk of cardiovascular death by 22% and the risk of all-cause death by 15% [ 7].
Figure 2.
The MACE risk of patients in the liraglutide group was reduced by 13%.
Since then, major domestic and foreign authoritative guidelines, including the 2017 version of the CDS guidelines, have also begun to pay attention to the cardiovascular outcome of T2DM patients with cardiovascular risk factors.
China's "Type 2 Diabetes Combinations" "Expert consensus on the application of hypoglycemic drugs in patients with atherosclerotic cardiovascular disease" has also emerged to help clinicians better provide more suitable and ideal treatments for diabetes patients with CVD [2, 8].
More evidence has emerged.
After the LEADER study of GLP-1 RA opened a new chapter in the treatment of diabetes, the cardiovascular benefits of hypoglycemic drugs have received widespread attention, and evidence of the cardiovascular benefits of other new hypoglycemic drugs has also been published[9-10], As the so-called one stone ignited a thousand waves, supported by evidence-based evidence, the status of GLP-1RA in major guidelines has risen.
The 2020 version of the "CDS Guidelines" just issued on April 19, 2021 also made a major update on the treatment path of T2DM patients [3], recommending the diagnosis of atherosclerotic cardiovascular disease (ASCVD) or high-risk factors, chronic kidney disease For T2DM patients with CKD, it is recommended to combine GLP-1RA and other blood glucose lowering drugs with cardiovascular benefits on the basis of life>
For patients without ASCVD or high-risk factors, heart failure, or CKD, GLP-1RA is also an important treatment for dual combination therapy (Figure 3).
Figure 3.
Treatment path for hyperglycemia in T2DM patients.
On May 14, 2020, liraglutide CV indication was approved: it is suitable for reducing the major cardiovascular adverse events (cardiovascular death, non-fatal) in adult patients with T2DM with cardiovascular disease The risk of severe myocardial infarction or non-fatal stroke) provides a solid guarantee for GLP-1RA drugs in the standardized diagnosis and treatment of patients with T2DM combined with cardiovascular disease.
Summary Liraglutide has been on the market in China for ten years, and the gratifying data brought by previous research is still fresh in memory.
A number of studies have shown that liraglutide can not only effectively reduce blood sugar, but also increase the proportion of patients who reach the composite endpoint of HbA1c + no weight gain + no hypoglycemia.
It is a more clinically ideal hypoglycemic drug. The LEADER study has also revealed the cardiovascular benefits of liraglutide, making it an ideal hypoglycemic drug for diabetic patients with CVD.
The approval of the CV indication for liraglutide is a new "weapon" for Chinese endocrinologists.
It is hoped that in the future it can help Chinese T2DM patients to reduce the risk of major cardiovascular adverse events and benefit more diabetes patients with CVD! References: [1] Diabetes Branch of Chinese Medical Association.
China Type 2 Diabetes Prevention and Control Guide: 2010 Edition [M].
Peking University Medical Press, 2011.
[2] Jia Weiping, et al.
Chinese Journal of Diabetes.
2018; 10(1 ):4-67.
[3] Diabetes Branch of Chinese Medical Association.
Chinese Journal of Diabetes.
2021;13(4):315-409.
[4]Yang W, et al.
Diabetes Obes Metab.
2011;13(1) :81-8.
[5] Diabetes Branch of Chinese Medical Association.
Chinese Journal of Diabetes.
2014;6(7):447-496.
[6]Zang L, et al.
Diabetes Obes Metab.
2016;18(8): 803-11.
[7]Marso SP, et al.
N Engl J Med.
2016;375(4):311-22.
[8]Hong Tianpei, et al.
Chinese Journal of Diabetes.
2017; 25(6):481 -492.
[9]Holman RR, et al.
N Engl J Med.
2017;377(13):1228-1239.
[10]Gerstein HC, et al.
Lancet.
2019;394(10193):121-130.
For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cn
