Comparative cardiovascular and renal outcomes of Liraglutide versus Dulaglutide in Asian type 2 diabetes patients

Abstract

Given the limited head-to-head comparison of cardiovascular and renal outcomes between liraglutide and dulaglutide, our study aimed to investigate the clinical outcomes between dulaglutide and liraglutide in a real-world setting. In this new-user design, comparative and retrospective cohort study, patients with type 2 diabetes mellitus with prescription for GLP-1RAs from January 1, 2016 to December 31, 2022 (n = 8,278) were included. Primary outcome was composite cardiovascular outcomes which was composed of cardiovascular death, non-fatal myocardial infarction, and non-fatal ischemic stroke. The composite renal outcome was also interested, including new macroalbuminuria, doubling of serum creatinine, worsening of estimated glomerular filtration rate (eGFR), and progression to dialysis. A total of 3,210 subjects receiving liraglutide and 5,068 subjects receiving dulaglutide were identified. In the adjusted cohort by applying inverse probability of treatment weighting, the incidence of composite cardiovascular outcomes was 18.4 and 18.7 events per 1000 person-years in the liraglutide and dulaglutide groups, respectively. The risk of cardiovascular outcomes did not significantly differ between groups (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.85-1.15). Moreover, the risk of composite renal outcomes was also comparable between groups (subdistribution HR 1.07, 95% CI 0.995-1.16). Liraglutide and dulaglutide demonstrated comparable cardiovascular and renal outcomes in a real-world setting.

Keywords: Cardiovascular outcomes; Dulaglutide; Liraglutide; Renal outcomes.

Fig. 1

The flowchart for the inclusion and exclusion of the study patients. GLP-1 RAs, glucagon-like peptide-1 receptor agonists.

Fig. 2

The cumulative event rates of non-fatal myocardial infarction (A), major adverse cardiovascular events (B), composite renal outcomes (C), and all-cause death (D) among patients who received liraglutide versus dulaglutide in the IPTW-adjusted cohort. IPTW inverse probability of treatment weighting, SHR subdistributional hazard ratio, CI confidence interval, HR hazard ratio.

Fig. 3

The change of systolic blood pressure (A), diastolic blood pressure (B), heart rate (C), body weight (D), glycated hemoglobin (E) and eGFR (F) from baseline to follow up measurements among patients who received liraglutide versus dulaglutide in the IPTW-adjusted cohort. IPTW inverse probability of treatment weighting, eGFR estimated glomerular filtration rate.