Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

Ronald M. Goldenberg; Alice Y.Y. Cheng; Tess Fitzpatrick; Jeremy D. Gilbert; Subodh Verma; Julia J. Hopyan

doi:10.1161/strokeaha.121.038151

journal article May 01, 2022

Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

Ronald M. Goldenberg

Stroke Vol. 53 No. 5 pp. 1813-1822 · Ovid Technologies (Wolters Kluwer Health)

View at Publisher Save 10.1161/strokeaha.121.038151

Abstract

People living with diabetes are at higher risk for stroke and have a poorer prognosis following a stroke event than those without diabetes. Data from cardiovascular outcome trials and meta-analyses indicate that GLP-1RAs (glucagon-like peptide 1 receptor agonists) reduce the risk of stroke in individuals with type 2 diabetes. Accordingly, many guidelines now recommend the addition of GLP-1RAs to ongoing antihyperglycemic regimens to lower the risk of stroke in type 2 diabetes. The current work summarizes evidence supporting the use of GLP-1RAs for stroke reduction in people with type 2 diabetes and offers 2 new resources for neurologists who are considering GLP-1RAs for their patients—a list of frequently asked questions with evidence-based answers on safely initiating and managing GLP-1RAs, and a practical decision-making algorithm to assist in using GLP-1RAs as part of a stroke reduction strategy.

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References

67

[1]

10.1161/strokeaha.113.001318

[2]

10.1371/journal.pone.0109960

[3]

10.1001/archinte.165.2.227

[4]

10.1097/md.0000000000002282

[5]

Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke

Justin B Echouffo-Tcheugui, Haolin Xu, Roland A Matsouaka et al.

European Heart Journal 10.1093/eurheartj/ehy036

[6]

10.2337/dc20-2304

[7]

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association

Dawn O. Kleindorfer, Amytis Towfighi, Seemant Chaturvedi et al.

Stroke 10.1161/str.0000000000000375

[8]

Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020

David J. Gladstone, M. Patrice Lindsay, James Douketis et al.

Canadian Journal of Neurological Sciences / Journa... 10.1017/cjn.2021.127

[9]

10.1016/j.nrl.2020.04.030

[10]

Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and management of diabetes in Canada. Can J Diabetes. 2018;42:S1–S325.

[11]

10.1016/s0140-6736(99)12323-7

[12]

10.1016/s0140-6736(02)08090-x

[13]

10.1016/s2213-8587(21)00203-5

[14]

Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials

The Lancet 10.1016/s0140-6736(09)60503-1

[15]

Efficacy of cholesterol-lowering therapy in 18 686 people with diabetes in 14 randomised trials of statins: a meta-analysis

The Lancet 10.1016/s0140-6736(08)60104-x

[16]

10.1001/jama.2014.18574

[17]

Stroke Outcomes in the COMPASS Trial

Mukul Sharma, Robert G. Hart, Stuart J. Connolly et al.

Circulation 10.1161/circulationaha.118.035864

[18]

Bhatt, DL, Brinton, EA, Miller, M, Steg, PG, Jacobson, TA, Ketchum, SB, Doyle, RT, Juliano, RA, Jiao, L, Granowitz, C, et al. Substantial cardiovascular benefit from icosapent ethyl in patients with diabetes: REDUCE-IT DIABETES. American Diabetes Association’s 80th Scientific Sessions Virtual. Late Breaking Poster Presentations: Acute and Chronic Complications. Diabetes. 2020;69:4–LB. 10.2337/db20-4-lb

[19]

10.1161/strokeaha.119.027759

[20]

10.1016/j.wneu.2020.01.056

[21]

10.1007/s00125-009-1470-0

[22]

10.1007/s00125-019-4920-3

[23]

10.1007/s00125-021-05436-0

[24]

10.1016/j.ahj.2020.12.007

[25]

10.1161/strokeaha.116.015756

[26]

10.1161/strokeaha.118.023009

[27]

10.1016/s0140-6736(05)67528-9

[28]

10.1161/01.str.0000257974.06317.49

[29]

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes

Steven P. Marso, Stephen C. Bain, Agostino Consoli et al.

New England Journal of Medicine 10.1056/nejmoa1607141

[30]

Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial

Hertzel C Gerstein, Helen M Colhoun, GILLES R DAGENAIS et al.

The Lancet 10.1016/s0140-6736(19)31149-3

[31]

10.1056/nejmoa1901118

[32]

Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes

Steven P. Marso, Gilbert H. Daniels, Kirstine Brown-Frandsen et al.

New England Journal of Medicine 10.1056/nejmoa1603827

[33]

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Adrian F Hernandez, Jennifer B Green, Salim Janmohamed et al.

The Lancet 10.1016/s0140-6736(18)32261-x

[34]

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes

Rury R. Holman, M. Angelyn Bethel, Robert J. Mentz et al.

New England Journal of Medicine 10.1056/nejmoa1612917

[35]

10.1056/nejmoa1509225

[36]

Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes

Hertzel C. Gerstein, Naveed Sattar, Julio Rosenstock et al.

New England Journal of Medicine 10.1056/nejmoa2108269

[37]

10.1016/s2213-8587(19)30423-1

[38]

Eli Lilly Canada Inc. PrTRULICITY® Product Monograph. September 11, 2020.

[39]

Eli Lilly and Company. TRULICITY® Prescribing Information. September 2020.

[40]

Food and Drug Administration. New drug application 209637 for semaglutide injection. Endocrinologic and Metabolic Drugs Advisory Committee Meeting Briefing Document. 2017:1–152.

[41]

Novo Nordisk. Semaglutide subcutaneous once-weekly - Treatment to improve glycemic control in adults with Type 2 diabetes mellitus. Endocrinologic and Metabolic Drugs Advisory Committee Meeting Briefing Document. 2017:1–158.

[42]

10.1186/s12933-019-0871-8

[43]

Strain, WD, Holst, AG, Rasmussen, S, Saevereid, HA, James, MA. Effects of liraglutide and semaglutide on stroke subtypes in patients with type 2 diabetes: a post hoc analysis of the LEADER, SUSTAIN 6 and PIONEER 6 trials. 56th EASD Annual Meeting of the European Association for the Study of Diabetes, Virtual Meeting. OP 47 Thinking about diabetes complications in the brain. Diabetologia. 2020;63:258.

[44]

Novo Nordisk A/S. A heart disease study of semaglutide in patients with type 2 diabetes (SOUL). 2019;2021.

[45]

Nuffield Dept of Population Health (University of Oxford). Major new study could help protect millions of people with type 2 diabetes from cardiovascular disease. University of Oxford News and Events. 2021

[46]

Novo Nordisk Inc. OZEMPIC® Prescribing Information. January 2020.

[47]

GLP-1 receptor agonists and cardiorenal outcomes in type 2 diabetes: an updated meta-analysis of eight CVOTs

Dario Giugliano, Lorenzo Scappaticcio, Miriam Longo et al.

Cardiovascular Diabetology 10.1186/s12933-021-01366-8

[48]

10.1161/strokeaha.119.027557

[49]

10.1007/s00415-020-09813-4

[50]

10.1093/eurheartj/ehaa082

Showing 50 of 67 references

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Details

Published: May 01, 2022
Vol/Issue: 53(5)
Pages: 1813-1822

Authors

R

Ronald M. Goldenberg

LMC Diabetes & Endocrinology, Canada (R.M.G.).

A

Alice Y.Y. Cheng

Trillium Health Partners, St Michael’s Hospital, University of Toronto, Canada (A.Y.Y.C.).

T

Tess Fitzpatrick

Mackenzie Health, Canada (T.F.).

J

Jeremy D. Gilbert

Sunnybrook Health Sciences Centre, University of Toronto, Canada (J.D.G.).

S

Subodh Verma

St Michael’s Hospital, University of Toronto, Canada (S.V.).

J

Julia J. Hopyan

Sunnybrook Health Sciences Centre, University of Toronto, Canada (J.J.H.).

Cite This Article

Ronald M. Goldenberg, Alice Y.Y. Cheng, Tess Fitzpatrick, et al. (2022). Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists. Stroke, 53(5), 1813-1822. https://doi.org/10.1161/strokeaha.121.038151

Benefits of GLP-1 (Glucagon-Like Peptide 1) Receptor Agonists for Stroke Reduction in Type 2 Diabetes: A Call to Action for Neurologists

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