Older patients treated with liraglutide demonstrated significantly decreased risks for major adverse cardiovascular events and all-cause death, according to data published in Annals of Internal Medicine.
“Comorbidities and complications associated with type 2 diabetes mellitus increase with age, making treatment of elderly persons with this condition challenging,” Matthew P. Gilbert, DO, MPH, associate professor at Larner College of Medicine at The University of Vermont, and colleagues wrote. “Clinical data on the effect of antihyperglycemic treatment on CV events in elderly persons are limited.”
Gilbert and colleagues conducted a post hoc analysis of the LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) trial to determine the CV effect of liraglutide in patients aged 75 years or older and 60 to 74 years with CVD risk factors, compared with placebo.
The researchers assessed time from baseline to the first major adverse cardiovascular event (MACE), including CV death, a nonfatal myocardial infarction or nonfatal stroke, as well as the frequency of serious adverse events.
Participants were randomly assigned to receive liraglutide or placebo in the LEADER trial. Of those, 836 were aged 75 years or older and 6,183 were aged 60 to 74 years. Baseline characteristics were matched between both treatment and age groups.
Regardless of treatment, patients aged 75 years or older experienced more MACEs than those aged 60 to 74 years. There was a 34% risk reduction in the frequency of MACEs and a 29% risk reduction in the frequency of expanded MACE outcomes among patients aged 75 years or older treated with liraglutide compared with those treated with placebo. These reductions were less prominent in patients aged 60 to 74 years.
Regardless of age, fewer other CV outcomes occurred in the liraglutide group than the placebo group. In patients aged 75 years or older, there was a 35% risk reduction in all-cause death with treatment with liraglutide vs. placebo. In patients aged 60 to 74 years, there was a 6% risk reduction in all-cause death with treatment with liraglutide versus placebo.
Serious adverse events were reported by 63.5% of patients aged 75 years or older and 49.5% of those aged 60 to 74 years. Nonserious medical events were reported by 61.7% of patients aged 75 years or older and 49.8% of those aged 60 to 74 years.
The adverse events that occurred most commonly were neoplasms (10.3% in patients aged 60 to 74 years vs. 14.2% and 75 years or older) and gastrointestinal disorders, such as diarrhea (1.2% vs. 2.8%), nausea (2.4% vs. 2.9%) and vomiting (1.1% vs. 1.2%).
“These results can help physicians make clinical decisions on optimal management of type 2 diabetes in elderly patients, a vulnerable population in which treatment options that evidently benefit important clinical end points are limited,” Gilbert and colleagues concluded. – by Alaina Tedesco
Disclosures: Gilbert reports receiving personal fees from Novo Nordisk and Sanofi. Please see study for all other authors’ relevant financial disclosures.