For patients with type 2 diabetes and a history of cardiovascular disease or current kidney disease, the risk for adverse cardiovascular events is lower with efpeglenatide, an exendin-based glucagon-like peptide 1 receptor agonist, than placebo, according to a study published online June 28 in the New England Journal of Medicine to coincide with the annual meeting of the American Diabetes Association, held virtually from June 25 to 29.
Hertzel C. Gerstein, M.D., from Hamilton Health Sciences in Canada, and colleagues conducted a trial of efpeglenatide among participants with type 2 diabetes and a history of cardiovascular disease or current kidney disease plus one or more cardiovascular risk factors. Participants were randomly assigned to receive weekly subcutaneous injections of efpeglenatide (2,717 participants) at a dose of 4 or 6 mg or placebo (1,359 participants).
The researchers found that an incident major adverse cardiovascular event occurred in 7.0 and 9.2 percent of those assigned to receive efpeglenatide and placebo, respectively, during a median follow-up of 1.81 years (3.9 and 5.3 events per 100 person-years, respectively; hazard ratio, 0.73; 95 percent confidence interval, 0.58 to 0.92; P < 0.001 for noninferiority; P = 0.007 for superiority). A composite renal outcome event occurred in 13.0 and 18.4 percent of those randomly assigned to receive efpeglenatide and placebo, respectively (hazard ratio, 0.68; 95 percent confidence interval, 0.57 to 0.79; P < 0.001).
“We are encouraged that this once-a-week injection safely and effectively reduced cardiovascular and progression of kidney disease in patients with long-standing diabetes who had a high prevalence of cardiovascular and kidney disease,” Gerstein said in a statement.