Dulaglutide, a glucagon-like peptide-1 receptor agonist: in the search for survival molecule

• Alexander S. Ametov
• Anna O. Nevolnikova
• Ekaterina A. Tertychnaya
• Olga A. Mishra

Abstract

Cardiovascular diseases are the Leading cause of mortality and a decline in the quality of Life in patients with T2DM. Therefore, multifactorial management is the basis of a strategic approach to the treatment of diabetes. Its basic principles include: control of glucose, blood pressure, low density lipoproteins, lifestyle modification, weight loss and smoking cessation. Current requirements for a sugar-lowering molecule are physiological glucose control, low risk of hypoglycemia, cardiovascular safety and protection combined with ease of use. In large-scale clinical trials, GLP-1 agonists have demonstrated various beneficial cardiovascular effects. REWIND is the longest-running study of the cardiovascular outcome of GLP-1 agonists with the prolonged action of dulaglutide. The results showed that weekly administration of dulaglutide at a dose of 1.5 mg was accompanied by a 12% reduction in the MACE complex in patients with type 2 diabetes with CVD or risk factors (HR 0.8; 95% CI 0.79-0.99; p=0.026): cardiovascular death (HR 0.91; 95% CI 0.79-1.06; p=0.21), non-fatal myocardial infarction (HR 0.96; 95% CI 0.79-1.16; p=0.65) and non-fatal stroke (HR 0.76; 95% CI 0.61-0.95; p=0.017). A positive effect on microvascular complications was to slow the progression of chronic kidney disease in patients with type 2 diabetes (HR 0.87; 95% CI 0.79-0.95). The pathogenetic mechanisms underlying the cebero-, reno- and cardipro-tective effects of dulaglutide have not been determined.

Keywords:diabetes mellitus 2, glucagon-like peptide-1 agonists, cardiovascular outcomes, cardioprotection, nephroprotection, dulaglutide, REWIND study

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)