OBJECTIVES: To evaluate the effectiveness of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide on glycemic control and cardiovascular outcomes among Chinese patients with Type 2 Diabetes Mellitus (T2DM).
METHODS: Data were collected from the hospital information system database covering 10 tertiary hospitals in Tianjin, China. Adult patients with T2DM who initiated liraglutide between January 1, 2016 and December 31, 2018 were identified, and followed up to December 31, 2019. Glycemic control was assessed by the differences in HbA1c levels and percentages of patients who achieved HbA1c <7% between 3-month pre-index period and 12-month post-index period among patients with available test results at both time windows. Incidence rates (events per 1000 person-years) of cardiovascular events including myocardial infarction, stroke, unstable angina, heart failure and their composite endpoint were compared by Exact Poisson Tests between baseline and the follow-up period.
RESULTS: 1624 liraglutide initiators were included (mean follow-up 1.6±0.7 years, mean age 52.5 ± 12.8 years, 56.8% male). The mean HbA1c was decreased from 8.6% to 7.8% (P<0.001) at 12-month after initiation, with percentage of patients achieved HbA1c <7% increased from 17.5% to 35.5% (P<0.001). Compared with the 12-month baseline estimates, the incidence rates for composite endpoint (20.9 vs. 7.9 events per 1000 person-years; RR 0.38; 95% C.I. 0.21–0.67) decreased significantly during the average duration of 1.6-years follow-up. Rates of myocardial infarction (8.0 vs. 3.0 events per 1000 person-years; RR 0.38; 95% C.I. 0.14–0.99;) and heart failure (4.9 vs. 0.7 events per 1000 person-years; RR 0.15; 95% C.I. 0.02–0.76) reduced after initiation, while no significant difference was observed regarding the incidence of stroke and angina.
CONCLUSIONS: Favorable effects on glycemic control and macrovascular benefits of liraglutide, regarding myocardial infarction and heart failure, were proved among Chinese patients with T2DM. Further study is still needed to capture the long-term effects of liraglutide.