Liraglutide appears to reduce the risk of major adverse cardiovascular events (MACE) in older people with type 2 diabetes mellitus (T2DM), according to a new post-hoc analysis of data from the LEADER trial.
The findings should "reassure clinicians that they can use these medications in elderly patients and still see those benefits that are seen in younger folks," Dr. Matthew P. Gilbert of Larner College of Medicine at the University of Vermont in Burlington, the study's senior author, told Reuters Health by phone. The findings were published online December 3 in the Annals of Internal Medicine.
Elderly hands. Source
The LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) study found the glucagon-like peptide-1 agonist reduced MACEs by 13% in high-risk patients with T2DM.
Dr. Gilbert and his colleagues looked at MACE in older LEADER participants, including 6,183 aged 60-74 and 836 who were 75 and older.
The oldest patients on liraglutide had a 34% reduction in MACE frequency compared to the placebo group, and all other CV outcomes occurred less often in patients on liraglutide compared to those on placebo regardless of age.
The reduction of all-cause death with liraglutide was 35% for the 75-and-older group and 6% for those 60 to 74 years old.
The risk of serious and non-serious medical events of special interest were lower in those aged 60 to 74 group than in the 75-and-older group, but these risks were similar in patients on placebo or liraglutide within each age group.
Gastrointestinal disorders occurred in 46.6% of patients on liraglutide versus 33% of the placebo group, and acute gallstone disease was also more frequent with active treatment (10% versus 6.3%).
"We have to take any kind of conclusions from a post-hoc analysis as exploratory in nature," Dr. Gilbert noted. Other study drawbacks include the small number of patients over 75 and the short follow-up period, he and his colleagues note in their report.
Nevertheless, they conclude, "These results can help physicians make clinical decisions on optimal management of T2DM in elderly patients, a vulnerable population in which treatment options that evidently benefit important clinical end points are limited."
Ann Intern Med 2018.