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- December 1, 2008 |
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"The Cardiovascular Profile of Current Therapies: What is the Verdict?"Dr. Trisha O'Moore-Sullivan (biography)
English - 2007-11-10 - 30 minutes
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Summary :
In a recent systematic review published by Bolen et al., there was no strong evidence found for CVD benefit of any particular oral agent compared to another in type 2 diabetes treatment (1). There is however a lingering concern about sulfonylureas and cardiovascular risk. Some evidence raises concern about potential harm from sulfonylureas, though these data are largely from retrospective and case-control studies.
The best randomised controlled data for metformin come from the UKPDS, which showed that in a small subset of overweight patients, metformin was associated with a significant reduction in the risk of myocardial infarction (2). Large retrospective database analyses also show reasonable evidence for benefit.
There is no evidence for harm with metformin or insulin, and there are no cardiovascular outcome data yet for GLP-1 analogues or DPP-4 inhibitors. Dr. O'Moore-Sullivan also talks about a systematic review by Eurich et al. on antidiabetic agents and morbidity and mortality in diabetic patients with heart failure (3).
Copyright © 2007 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Results of a systematic review of the comparative effectiveness and safety of oral medications for type 2 diabetes (Bolen et al. Ann Int Med 2007)
- Data on sulfonylureas, metformin and insulin with respect to cardiovascular outcomes
- A systematic review of the literature on antidiabetic agents and morbidity and mortality in patients with diabetes and heart failure (Eurich et al., BMJ 2007)
Bibliographic references :
1. Shari Bolen et al. Systematic Review: Comparative Effectiveness and Safety of Oral Medications for Type 2 Diabetes Mellitus Ann Int Med 18 September 2007 | Volume 147 Issue 6 | Pages 386-399.
2. UK Prospective Diabetes Study (UKPDS) Group Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) The Lancet Volume 352, Issue 9131, 12 September 1998, Pages 854-865.
3. Dean T Eurich et al.Benefits and harms of antidiabetic agents in patients with diabetes and heart failure: systematic review BMJ 2007;335:497.
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