Evidence map›Paper›PMID 28910237›Full record

Trial reportThe New England journal of medicine2017

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Rury R Holman, M Angelyn Bethel, Robert J Mentz, Vivian P Thompson, Yuliya Lokhnygina, John B Buse, Juliana C Chan, Jasmine Choi, Stephanie M Gustavson, Nayyar Iqbal and 9 more

Registry-linked trialOpen access · bronzeAbstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01144338 (Exenatide Study of Cardiovascular Event Lowering Trial), which is not on this map. Cited by 918 papers, 36 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
918citing papers in PubMed, 36 pooled it
151.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01144338 phase3completednot on this map

Exenatide Study of Cardiovascular Event Lowering Trial (EXSCEL). A Randomized, Placebo Controlled Clinical Trial to Evaluate Cardiovascular Outcomes After Treatment With Exenatide Once Weekly in Patients With Type 2 Diabetes Mellitus.

TypeinterventionalSponsorAstraZenecaRan2010 to 2017Enrolled14,752ConditionsType 2 Diabetes MellitusArmsExenatide Once Weekly, Placebo
3 · Its place in the literature

Who cites it

918 citing papers in PubMed, 36 syntheses or guidelines pooled it, 2,089 citations in OpenAlex.

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  9. The effect of GLP-1 receptor agonists on renal outcomes: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
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858 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 8 institutions in 6 countries.

Rury R HolmanFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
M Angelyn BethelFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Robert J MentzFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Vivian P ThompsonFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Yuliya LokhnyginaFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
John B BuseFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Juliana C ChanFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Jasmine ChoiFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Stephanie M GustavsonFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Nayyar IqbalFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Aldo P MaggioniFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Steven P MarsoFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Peter ÖhmanFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Neha J PagidipatiFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Neil PoulterFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Ambady RamachandranFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Bernard ZinmanFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
Adrian F HernandezFrom the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford (R.R.H., M.A.B.), and the International Centre for Circulatory Health, Imperial College London, London (N.P.) - both in the United Kingdom; Duke Clinical Research Institute, Duke University School of Medicine, Durham (R.J.M., V.P.T., Y.L., N.J.P., A.F.H.), and the Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill (J.B.B.) - both in North Carolina; the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong (J.C.C.); AstraZeneca Research and Development, Gaithersburg, MD (J.C., S.M.G., N.I., P.Ö.); Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center, Florence, Italy (A.P.M.); the Department of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.P.M.); the India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India (A.R.); and the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto (B.Z.).
EXSCEL Study Group
Chinese University of Hong Kong · CNOxford Centre for Diabetes, Endocrinology and Metabolism · GBAssociazione Nazionale Medici Cardiologi Ospedalieri · ITDuke University · USClinical Research Institute · USImperial College London · GBIndia Diabetes Research Foundation · INLunenfeld-Tanenbaum Research Institute · CA

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
NHLBI NIH HHS T32 HL069749
6 · The paper itself

Abstract

backgroundThe cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown.

methodsWe randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy.

resultsIn all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups.

conclusionsAmong patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .).

Indexed as

AgedCardiovascular DiseasesDiabetes Mellitus, Type 2Double-Blind MethodDrug Administration ScheduleExenatideFemaleHumansHypoglycemic AgentsIncidenceInjections, SubcutaneousKaplan-Meier EstimateLeast-Squares AnalysisMaleMiddle AgedPeptidesExenatideHypoglycemic AgentsPeptidesVenoms

Identifiers

PMID28910237
PMCPMC9792409
OpenAlexW2754041380

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.