A New Meta-Analysis Affirms Cardiorenal Benefits for GLP-1s
For the second time this year, we have a meta-analysis of RCTs with GLP-1 medicines that affirms cardiorenal benefits in outcome studies. This latest study appears in Lancet Diabetes and Endocrinology. Lead author Sunil Badve described the importance of his analysis:
“This is the first study to show a clear benefit of GLP-1 receptor agonists on kidney failure or end-stage kidney disease, suggesting they have a key role in kidney-protective and heart-protective treatment for patients with common medical conditions like type 2 diabetes, overweight or obesity with cardiovascular disease, or CKD [chronic kidney disease].
“These results are particularly important for patients with chronic kidney disease. It is a progressive condition eventually leading to kidney failure requiring dialysis or kidney transplantation and is associated with premature death, mostly from heart disease. It has a significant impact on patients’ quality of life and incurs substantial healthcare costs.”
In plain English, this means that the evidence is adding up to show that people treated with these remarkable drugs will live longer, healthier lives if they have obesity, heart, and kidney disease.
The Scope of Benefits from Treating Obesity
What is emerging – and will likely continue – is an appreciation for the full scope of benefits from treating obesity. For folks with a weight-centric view of obesity, this is confusing. They tend to regard these outcomes as somehow separate from treating obesity. CMS reflects this in their policies for Medicare by rejecting the coverage of obesity medicines used specifically for obesity in people without cardiovascular disease, while accepting it for people with obesity and cardiovascular disease.
But the truth is that obesity is a metabolic disease with profound effects on cardiovascular, renal, liver, musculoskeletal, respiratory, and oncologic outcomes. We are seeing the benefits of GLP-1 therapy in cardiorenal outcomes become clear. Data on liver disease is coming, as are data on sleep apnea and osteoarthritis. So far, we have only suggestions of an effect in cancer outcomes and it will likely take some time for that picture to be clear.
But make no mistake. Treating obesity is all about preventing its complications – not just losing weight. It’s getting harder and harder to pretend otherwise.
Click here for the study by Badve et al and here for meta-analysis published earlier this year by Frederick Berro Rivera and colleagues. For further perspective, click here and here.
Stairwell and Kidney-Shaped Capstone, photograph by Villy Fink Isaksen, licensed under CC BY-SA 3.0
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November 26, 2024
