← GLP-1 receptor agonists × cardiovascular events

SynthesisDiabetes, obesity & metabolism2016

Achieving the composite endpoint of glycated haemoglobin <7.0%, no weight gain and no hypoglycaemia in the once-weekly dulaglutide AWARD programme.

K M Dungan et al.PubMed ↗Full text ↗Publisher ↗

  • Dulaglutide 1.5 mglooks bad hereHigher composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia, no clear effect on composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia.Randomised, small.
  • Dulaglutide 0.75 mglooks bad hereHigher composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia.Randomised, small.

What the trial testedrandomised · 2016

Randomised vs sitagliptin

Probably raised composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia

4.5×3× to 6.6×

dulaglutide 1.5 mg vs sitagliptin

Bigger than almost all for cardiovascular events

As reported

OR 4.5, 95% CI 3.00–6.60

Randomised vs exenatide twice daily

Probably raised composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia

2.6×1.8× to 3.7×

dulaglutide 1.5 mg vs exenatide twice daily

Bigger than 9 in 10 for cardiovascular events

As reported

OR 2.6, 95% CI 1.80–3.70

Randomised vs insulin glargine

Probably raised composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia

7.4×4.4× to 13×

dulaglutide 1.5 mg vs insulin glargine

Bigger than almost all for cardiovascular events

As reported

OR 7.4, 95% CI 4.40–12.6

Randomised vs sitagliptin

Probably raised composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia

3.3×2.2× to 4.8×

dulaglutide 0.75 mg vs sitagliptin

Bigger than almost all for cardiovascular events

As reported

OR 3.3, 95% CI 2.20–4.80

+2 more in the walkthrough ↓

Who was studied, and how

people with type 2 diabetes, in this paper

The trial randomly assignedassigned by chance

dulaglutide 1.5 mg
metformin

No clear effect on composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia1.5×

randomised

The trial randomly assignedassigned by chance

dulaglutide 1.5 mg
sitagliptin

Probably raised composite endpoint of HbA1c <7.0% , no weight gain and no hypoglycaemia4.5×

randomised

the abstract, start to end

… the composite endpoint with dulaglutide 1.5 mg than with metformin, sitagliptin, exenatide twice daily or insulin glargine: odds ratio (OR) 1.5 [95% confidence interval (CI) 1.0, 2.2; p < 0.05], OR 4.5 (95% CI 3.0, 6.6; p < 0.001), OR 2.6 (95% CI 1.8, 3.7; p < 0.001) and OR 7.4 (95% CI 4.4, 12.6; p < 0.001), …

… with sitagliptin or insulin glargine: OR 3.3 (95% CI 2.2, 4.8; p < 0.001) and OR 4.5 (95% CI 2.7, 7.8; p < 0.001), …

← favours treatmentfavours comparator →
could be chance
Composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia)dulaglutide 1.5 mg vs metformin
OR 1.51.00–2.20
Composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia)dulaglutide 1.5 mg vs sitagliptin
OR 4.53.00–6.60
Composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia)dulaglutide 1.5 mg vs exenatide twice daily
OR 2.61.80–3.70
Composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia)dulaglutide 1.5 mg vs insulin glargine
OR 7.44.40–12.6
Composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia)dulaglutide 0.75 mg vs sitagliptin
OR 3.32.20–4.80
Composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia)dulaglutide 0.75 mg vs insulin glargine
OR 4.52.70–7.80
GLP-1 receptor agonistsCardiovascular events
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