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Experimental Diabetes Research
Volume 2011, Article ID 215764, 10 pages
http://dx.doi.org/10.1155/2011/215764
Research Article

Glucagon-Like Peptide-1 Receptor Agonists and Cardiovascular Events: A Meta-Analysis of Randomized Clinical Trials

1Section of Geriatric Cardiology and Medicine, Department of Cardiovascular Medicine, University of Florence and Careggi Teaching Hospital, 50141 Florence, Italy
2Diabetes Agency, University of Florence and Careggi Teaching Hospital, 50141 Florence, Italy
3Section of Geriatric Cardiology and Medicine, Department of Cardiovascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Pieraccini Avenue 18, 50141 Florence, Italy

Received 26 December 2010; Accepted 22 February 2011

Academic Editor: Giovanni Di Pasquale

Copyright © 2011 Matteo Monami et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Data from randomized clinical trials with metabolic outcomes can be used to address concerns about potential issues of cardiovascular safety for newer drugs for type 2 diabetes. This meta-analysis was designed to assess cardiovascular safety of GLP-1 receptor agonists. Design and Methods. MEDLINE, Embase, and Cochrane databases were searched for randomized trials of GLP-1 receptor agonists (versus placebo or other comparators) with a duration ≥12 weeks, performed in type 2 diabetic patients. Mantel-Haenszel odds ratio with 95% confidence interval (MH-OR) was calculated for major cardiovascular events (MACE), on an intention-to-treat basis, excluding trials with zero events. Results. Out of 36 trials, 20 reported at least one MACE. The MH-OR for all GLP-1 receptor agonists was 0.74 (0.50–1.08), (0.85 (0.50–1.45), , and 0.69 (0.40–1.22), , for exenatide and liraglutide, resp.). Corresponding figures for placebo-controlled and active comparator studies were 0.46 (0.25–0.83), , and 1.05 (0.63–1.76), , respectively. Conclusions. To date, results of randomized trials do not suggest any detrimental effect of GLP-1 receptor agonists on cardiovascular events. Specifically designed longer-term trials are needed to verify the possibility of a beneficial effect.