Positioning on GLP-1 receptor agonists

Abstract

Diabetes Mellitus is a leading cause of premature disease and death. The cardiovascular risk in people with diabetes is double or triple that of individuals without it. Early diagnosis and adequate glycemic control have conclusively shown a reduction in micro and macrovascular complications. International guidelines suggest a personalized treatment approach to reduce the risk of  complications related to the disease, and the use of drugs with proven cardiovascular benefit and low risk of hypoglycemia. Based on the recommendations of the Food and Drug Administration in 2008, all clinical trials have included the assessment of cardiovascular safety. This position statement of the Argentine Federation of Cardiology considers that the glucagon-like peptide 1 (Ar-GLP1) receptor agonist’s liraglutide, semaglutide, and dulaglutide should be considered as a therapeutic option in patients with established cardiovascular disease or in patients with high o very high cardiovascular risk to prevent cardiovascular events, and
liraglutide to reduce the risk of death. The Ar-GLP1 lixisenatide, liraglutide, semaglutide, exenatide, and dulaglutide have neutral effects on the risk of hospitalizations for heart failure, and can be safely considered for the treatment of diabetes mellitus in patients with heart failure. Treatment with Ar-GLP1 liraglutide and semaglutide is associated with a lower risk of renal end points, so they should be considered for the treatment of diabetes mellitus if the GFR is >30 ml / min / 1.73m2.