Critical Review On Liraglutide For Weight Management
Liraglutide is a glucagon like peptide‐1 (GLP‐1) receptor agonist, is a 1.8 mg daily subcutaneous injection was initially approved by the FDA in 2010 as an adjunct therapy to diet and exercise for management of type 2 diabetes. Results from clinical trials repeatedly demonstrated the ability of GLP‐1 analogs to induce weight loss. As a result, liraglutide was also developed as a weight loss agent and its 3.0 mg daily dose has shown encouraging results in multiple phase III clinical trials. Liraglutide is the newest FDA approved drug for chronic weight management in patients with obesity or who are overweight with a BMI ≥27 kg/m2 and have a weight related comorbid condition. The objective of study will review the efficacy, safety, and clinical applicability of liraglutide for weight management from phase III clinical trials.
Ticagrelor For High-Risk Coronary Artery Disease Patients
Patients with both coronary artery disease and type 2 diabetes mellitus are at high risk for cardiovascular events. Platelet-mediated thrombosis is a major mechanism contributing to ischemic events, and the higher risk among patients with diabetes is due in part to increased platelet activation. Therefore, aspirin alone, the standard therapy in this population, may not provide fully effective antithrombotic protection. Ticagrelor, a reversible antagonist of the platelet P2Y12 receptor, has been shown to provide more consistent platelet inhibition than aspirin or clopidogrel. Ticagrelor has also been shown to provide protection against cardiovascular events when added to aspirin in patients with acute coronary syndromes and in high-risk patients with previous myocardial infarction. The Effect of Ticagrelor on Health Outcomes in Diabetes Mellitus Patients Intervention Study (THEMIS) was designed to test the efficacy and safety of ticagrelor, as compared with placebo, in addition to aspirin in this population.
SGLT2 Inhibitors Protect Kidney Failure In Patients With Type 2 Diabetes
The effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on kidney failure, particularly the need for dialysis or transplantation or death due to kidney disease, is uncertain. Additionally, previous studies have been underpowered to robustly assess heterogeneity of effects on kidney outcomes by different levels of estimated glomerular filtration rate (eGFR) and albuminuria. This study aimed to do a systematic review and meta-analysis to assess the effects of SGLT2 inhibitors on major kidney outcomes in patients with type 2 diabetes and to determine the consistency of effect size across trials and different levels of eGFR and albuminuria.
Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes
Dapagliflozin is a selective inhibitor of sodium–glucose cotransporter 2 (SGLT2) that blocks glucose resorption in the proximal tubule of the kidney and promotes glucosuria. Other SGLT2 inhibitors have shown favorable cardiovascular effects, including a reduction in the risk of hospitalization for heart failure, predominantly in patients with type 2 diabetes and established cardiovascular disease; they have also been shown to delay the progression of kidney disease. The Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58 (DECLARE–TIMI 58) trial evaluated the effects of dapagliflozin on cardiovascular and renal outcomes in a broad population of patients who had or were at risk for atherosclerotic cardiovascular disease.