Key result
Liraglutide decreased MR-proANP by 12% (P=0.002) and NT-proBNP by 9% (P=0.009) compared with placebo in HFrEF patients, with the reduction observed exclusively in those with concomitant T2D.
Why the study?
The study aimed to assess the effect of the GLP-1 receptor agonist liraglutide on natriuretic peptides, adrenomedullin, and copeptin in patients with HFrEF with and without type 2 diabetes.
Does liraglutide reduce natriuretic peptide levels in patients with HFrEF with and without type 2 diabetes?
RCT (n=231)
randomized
Does liraglutide reduce natriuretic peptide levels in patients with HFrEF with and without type 2 diabetes?
Liraglutide significantly reduces natriuretic peptides in HFrEF patients with concomitant type 2 diabetes, but not in those without diabetes.
Liraglutide may reduce natriuretic peptides in HFrEF with T2D; leaves open clinical relevance pending dedicated outcome trials.
AIM: To assess the effect of liraglutide, a glucagon-like peptide-1 receptor agonist, on urinary sodium excretion as well as on circulating adrenomedullin and copeptin levels in patients with type 2 diabetes (T2D). MATERIALS AND METHODS: In the LIVE study, patients (n = 241) with left ventricular ejection fraction ≤45% were randomized to liraglutide 1.8 mg daily or placebo for 24 weeks, and 30% had a concomitant diagnosis of T2D. Plasma levels of N-terminal brain-natriuretic-peptide (NT-proBNP) (a predefined secondary endpoint), midregional pro-atrial-natriuretic-peptide (MR-proANP), midregional pro-adrenomedullin (MR-proADM) and copeptin were measured at baseline and after 24 weeks in this substudy. The potential effect modification of T2D was assessed. RESULTS: In the eligible subgroup of 231 patients with available biomarkers (115 randomized to liraglutide and 116 to placebo), MR-proANP decreased by 12% (P = .002) and NT-proBNP by 9% (P = .009) during liraglutide treatment compared with placebo at week 24. Interaction with T2D for the treatment effect of change in MR-proANP and NT-proBNP levels was P = .003 and P = .03, respectively. Consequently, in patients with T2D, liraglutide decreased MR-proANP by 27% (P < .001) and NT-proBNP by 25% (P = .02) compared with placebo, whereas no change was observed in patients without T2D. There was no effect of liraglutide on MR-proADM (P = .10) or copeptin (P = .52). CONCLUSION: Liraglutide decreased the A- and B-type natriuretic peptides significantly in patients with heart failure with reduced ejection fraction (HFrEF) and concomitant T2D, suggesting a beneficial mechanism of liraglutide in T2D patients with HFrEF.
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Nielsen et al. (2020) conducted an RCT in Heart failure with reduced ejection fraction (HFrEF) (n=231). Liraglutide vs. Placebo was evaluated on Change in MR-proANP level (12% decrease, p=.002). Liraglutide decreased MR-proANP by 12% (P=0.002) and NT-proBNP by 9% (P=0.009) compared with placebo in HFrEF patients, with the reduction observed exclusively in those with concomitant T2D.
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