Walnut Heart

Liraglutide and Heart Disease

If you thought that the onslaught of new studies was done with the closing of ObesityWeek on Friday, think again. Now we have two important new studies of liraglutide and heart disease that were presented at the Annual Scientific Sessions of the American Heart Association (AHA) on Sunday and Monday.

The study that’s hogging all the headlines is called the FIGHT (Functional Impact of GLP-1 for Heart failure Treatment) study. With this study, the investigators wanted to test the possibility that liraglutide (a GLP-1 agonist) would serve to stabilize high-risk heart failure patients. It did not. For the primary endpoint of the study, a global rank endpoint, they found no significant difference between the group that received placebo and the group that received liraglutide at the lower doses used to treat diabetes. At those lower doses, liraglutide is sold under the brand name of Victoza for diabetes. At a higher dose, it’s sold as Saxenda for obesity.

So naturally, newspapers are splashing headlines everywhere about how liraglutide doesn’t work for heart failure. For most readers of health news, we’re not sure this is helpful. The supposition that it might help was a hypothesis, not something that most clinicians were counting on — let alone consumers, even those who know quite a bit about liraglutide. Caroline Apovian, Professor of Medicine at the Boston University School of Medicine, summed it up:

I am not especially surprised by this finding. Stabilization for high risk heart failure patients using GLP-1 is a little too late in the game. Perhaps earlier, when there is myocardium at risk and better glucose utilization can save myocardium, it might be beneficial.

The other news coming out of the AHA meeting about liraglutide is actually a bit more relevant because it is a pooled analysis of cardiovascular safety data from studies in both diabetes and obesity. The primary endpoint was major adverse cardiovascular events (MACE) — things like deaths, heart attacks, and strokes. The bottom line in this study was a lower incidence of MACE in patients treated with liraglutide.

The next major milestone will be the completion of the LEADER study, which was designed to test for the possibility of a benefit in cardiovascular outcomes with liraglutide in diabetes. Those results are expected by the end of the first quarter of 2016 and will be presented at the American Diabetes Association meeting in June.

In the words of Novo Nordisk’s Chief Science Officer Mads Krogsgaard Thomsen, “I cannot guarantee anything. It will be very exciting.”

Watch this space.

Click here and here for more on the study of liraglutide in heart failure. Click here for a sample of health reporting on it. Click here for more on the study of MACE in liraglutide for diabetes and obesity. Click here for more on the LEADER study.

Walnut Heart, photograph © Martin Fisch / flickr

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November 10, 2015