GLP-1 receptor agonists (GLP-1 RA) medications can reduce the number of deaths, amputations and hospitalisations among patients with peripheral arterial disease (PAD) and type 2 diabetes, according to new, independent research published in the Journal of the American Heart Association (JAHA).
“Because GLP-1 RAs show significant benefits, especially for high-risk patients with severe circulation problems in their legs, clinicians should consider prescribing GLP-1s because [PAD] has limited treatment options,” said study author and interventional cardiologist Aravinda Nanjundappa (Cleveland Clinic, Cleveland, USA). “Our findings indicate these medications may improve long-term health for people with PAD, in addition to managing blood sugar and weight loss.”
In this study, researchers reviewed the health records for more than 2,000 adults with PAD and type 2 diabetes to explore the potential benefits of GLP-1 RA medications. They found that the positive impact of GLP-1 RAs on overall health surpassed that of metformin, the most widely prescribed medication for people with type 2 diabetes, in most categories.
Compared with people taking metformin, among those taking GLP-1 RAs, the analysis found a 26% reduction in all causes of death; a 13% reduction in hospitalisations; up to a 48% reduction in amputations; and about 36% reduction in the need for revascularisation. However, the rate of heart attack, stroke and serious kidney events were similar between both groups.
Researchers noted that the link between GLP1-RAs and medical benefits was strongest among participants with severe PAD, including chronic limb-threatening ischaemia (CLTI) and those with a body mass index of 30 or higher, which is considered obesity.
“Obesity and PAD, including chronic limb-threatening ischaemia, are linked to increased inflammation, poor blood vessel function, insulin resistance, oxidative stress and faster hardening of the arteries,” said study co-author Akiva Rosenzveig, a cardiology fellow at the Cleveland Clinic. “These results indicate GLP1-RAs can help reduce inflammation, improve blood vessel function and manage blood sugar levels.”
The study’s strengths include analysing a large group of people and examining both death rates and issues related to limbs. For the comparison group, participants had to have received at least five metformin prescriptions and no GLP-1 RA prescriptions during the study period. This approach strengthened the analysis results, according to Nanjundappa and colleagues.
However, the authors note that the study was limited in that it could not prove cause and effect. Additionally, electronic health records may have diagnostic coding errors that would impact the results of the analysis.
