Patients with type 2 diabetes and established atherosclerotic cardiovascular disease were significantly less likely to be prescribed GLP-1 receptor agonists compared to those without ASCVD (OR 0.80).
Meta-Analysis (n=2,770,353)
Yes
Is the use of GLP-1RAs different in T2DM patients with versus without ASCVD in real-world clinical practice?
Despite guideline recommendations, GLP-1RAs are paradoxically underused in real-world clinical practice among T2DM patients with established ASCVD compared to those without ASCVD.
Odds Ratio: 0.8 (95% CI 0.79–0.81)
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce the risk of cardiovascular (CV) complications in patients with type 2 diabetes (T2DM) and atherosclerotic cardiovascular disease (ASCVD) in placebo-controlled CV outcome trials, yet the use of these cardioprotective agents remains rather low in clinical practice. Analysis of the proportion of T2DM patients treated with GLP-1RAs in retrospective observational studies by comparing patients with versus without established ASCVD. Nine cohorts from seven studies were collected in the international literature between 2019 and 2022. Overall, the percentages of patients treated with GLP-1RAs were low (< 10 %) in most studies, yet a progressive increase was noticed over time. The use of GLP-1RAs in patients with ASCVD was slightly lower in 7 out of 9 cohorts not higher when compared to the use in patients without ASCVD (odds ratio 0.80, 95 % CI 0.79–0.81). Despite a positive trend over the last decade, the real-world use of GLP-1RAs remains limited, especially in patients with established ASCVD. Bridging the gap between clinical evidence of cardioprotective effects of GLP-1RAs and their underuse in clinical practice in T2DM patients at high/very high CV risk should be considered as a key objective for health care providers, especially cardiologists.
André Scheen (Fri,) conducted a meta-analysis in Type 2 diabetes mellitus (n=2,770,353). Atherosclerotic cardiovascular disease (ASCVD) vs. Without ASCVD was evaluated on Prescription of GLP-1 receptor agonists (OR 0.80, 95% CI 0.79-0.81). Patients with type 2 diabetes and established atherosclerotic cardiovascular disease were significantly less likely to be prescribed GLP-1 receptor agonists compared to those without ASCVD (OR 0.80).