Сердечно-сосудистая фармакология: открытый доступ

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Underuse and Misuse of Newer Antidiabetic Medications with Established Positive Cardiovascular Outcome

Syed Raza

Diabetes is a growing problem globally despite all advances in its management strategy. In the last decade particularly there has been a plethora of newer anti-diabetic medications that have been introduced in the market. Recent trials and studies have shown promising results in terms of cardiovascular event reduction using some newer classes of anti-diabetic medications such as GLP1 agonist and SGLT2 inhibitors. There are now well-established guidelines on use of these medications in certain group of patients. The pathophysiology of how they work, and their potential benefit are now well understood. Despite clear recent guidelines, a significant proportion of patients with established or risk of CVD are not on appropriate anti-diabetic medications. It is therefore needed that practicing physicians are educated and made aware of the use of these medications. At the same time, they also need to be aware of any side effects and contraindications and therefore use them judiciously. A wiser decision and choice of these agents should be made in partnership with the patient after they are adequately educated of the proposed new medication. Recent trials suggested that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose co-transporter-2 (SGLT-2) inhibitors reduced cardiovascular events. Comparative effectiveness of these new antidiabetic drug classes remains unclear. We therefore performed a network meta-analysis to compare the effect on cardiovascular outcomes among GLP-1 RAs, SGLT-2 and dipeptidyl peptidase-4 (DPP-4) inhibitors.