Abstract
Purpose
The Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial showed the cardiovascular disease (CVD) benefits of liraglutide therapy among patients with type 2 diabetes mellitus (T2DM). We applied this trial to US adults with T2DM in terms of eligibility and preventable CVD events.
Methods
We included US adults with T2DM from the National Health and Nutrition Examination Survey (NHANES) 2007–2016. Eligibility criteria from LEADER primary and secondary prevention cohorts were applied to determine potentially eligible US adults. We estimated the number of primary composite and secondary CVD endpoints that would occur based on LEADER treated and placebo published event rates, with the difference indicating the number of preventable events.
Results
Among 4672 (projected to 27.3 million [M]) adults we identified with T2DM, we estimated 800 (4.2 million) (15.4%) to fit LEADER eligibility criteria, including 205 (0.9 M) primary prevention 595 (3.3 M) secondary prevention subjects. Compared to LEADER trial participants, our sample had higher proportions of women and minorities, prior angina, chronic kidney disease, and lipid-lowering medication use. We estimated 21,209 primary composite CVD events, 29,691 extended CVD composite outcomes, 16,967 all-cause deaths, 16,967 cardiovascular deaths, 12,725 myocardial infarctions, and 12,725 microvascular events would be prevented annually if our eligible T2DM subjects were on liraglutide.
Conclusion
Liraglutide may prevent many fatal and non-fatal CVD events if provided to US adults meeting LEADER eligibility criteria. More efforts are needed to educate the healthcare providers on the CVD benefits from newer diabetes therapies, including liraglutide.
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Funding
This independent research was supported by unrestricted ISS grant funding from Novo Nordisk Inc. to the University of California, Irvine.
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This project involved publicly accessible de-identified data and thus did not meet our University’s definition for human subject research.
Conflict of Interest
Dr. Wong receives research support from Novo Nordisk, Boehringer-Ingelheim, Amarin, Amgen, and Novartis, has served on an advisory board for Esperion, and is on the speakers bureau for Amarin and Sanofi. No other authors have any disclosures.
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Fan, W., Tong, C. & Wong, N.D. LEADER Trial Eligibility and Preventable Cardiovascular Events in US Adults with Diabetes: the National Health and Nutrition Examination Surveys 2007–2016. Cardiovasc Drugs Ther 34, 737–743 (2020). https://doi.org/10.1007/s10557-020-07032-7
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DOI: https://doi.org/10.1007/s10557-020-07032-7