Cardiovascular outcomes of liraglutide in patients with type 2 diabetes A systematic review and meta-analysis

Background: Liraglutide is a novel, long-acting glucagon-like peptide-1 (GLP-1) analogue used to treat type 2 diabetes mellitus. However, the cardiovascular safety and benefits of liraglutide treatment on type 2 diabetes patients remain in debate. In this study, we aimed to examine the overall cardiovascular outcomes of liraglutide in patients with type 2 diabetes. Methods: In this systematic review and meta-analysis, we searched the PubMed, Embase, and Web of Knowledge databases up to September 1st, 2017 for randomized trials in which type 2 diabetes patients were assigned to liraglutide and placebo or other comparators groups. Results: Eight studies fulfilled the eligibility criteria for inclusion and 14,608 patients were analyzed in this systematic review and meta-analysis. We found patients in the liraglutide group had a lower risk of major cardiovascular events (MACE) (RR=0.89, 95% CI: 0.82-0.96, P=.002), acute myocardial infarction (AMI) (RR=0.85, 95% CI: 0.74-0.99, P=.036), all-cause death (RR=0.84, 95% CI: 0.74-0.96, P=.009), and cardiovascular death (RR=0.77, 95% CI: 0.65-0.91, P=.002) than all comparator groups. However, liraglutide treatment did not decrease incidence of stroke (RR=0.86, 95% CI: 0.70-1.04, P=.124). But among the MACE subgroups analysis, a significant reduction of MACE with liraglutide was only observed in placebo-controlled trials (RR= 0.89, 95% CI: 0.83-0.96, P=.004) but not in studies concerning other comparators (RR=0.58, 95% CI: 0.29-1.16, P=.122). Conclusions: In conclusion, our results suggest that liraglutide treatment decreases the risk of MACE, AMI, all-cause death and cardiovascular death among patients with type 2 diabetes.