Risk of stroke and retinopathy during GLP-1 receptor agonist cardiovascular outcome trials: An eight RCTs meta-analysis

Jinjing Wei; Bing Yang; Ruxin Wang; Haowen Ye; Ying Wang; Lihong Wang; Xiaofang Zhang

doi:10.3389/fendo.2022.1007980

Risk of stroke and retinopathy during GLP-1 receptor agonist cardiovascular outcome trials: An eight RCTs meta-analysis

Front Endocrinol (Lausanne). 2022 Dec 5:13:1007980. doi: 10.3389/fendo.2022.1007980. eCollection 2022.

Authors

Jinjing Wei¹, Bing Yang¹, Ruxin Wang¹, Haowen Ye¹, Ying Wang¹, Lihong Wang^{1

2}, Xiaofang Zhang³

Affiliations

¹ Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China.
² The Guangzhou Key Laboratory of Basic and Translational Research on Chronic Diseases, The First Affiliated Hospital, Jinan University, Guangzhou, China.
³ Department Clinical Experimental Center, First Affiliated Hospital of Jinan University, Guangzhou, China.

Abstract

Purpose: To explore the risk of stroke (including ischemic and hemorrhagic stroke) in type 2 diabetes mellitus treated with glucagon-like peptide 1 receptor agonist (GLP-1RA) medication according to data from the Cardiovascular Outcome Trials(CVOT).

Methods: Randomized controlled trials (RCT) on GLP-1RA therapy and cardiovascular outcomes in type 2 diabetics published in full-text journal databases such as Medline (via PubMed), Embase, Clinical Trials.gov, and the Cochrane Library from establishment to May 1, 2022 were searched. We assess the quality of individual studies by using the Cochrane risk of bias algorithm. RevMan 5.4.1 software was use for calculating meta- analysis.

Results: A total of 60,081 randomized participants were included in the data of these 8 GLP-1RA cardiovascular outcomes trials. Pooled analysis reported statistically significant effect on total stroke risk[RR=0.83, 95%CI(0.73, 0.95), p=0.005], and its subtypes such as ischemic Stroke [RR=0.83, 95%CI(0.73, 0.95), p=0.008] from treatment with GLP-1RA versus placebo, and have no significant effect on the risk of hemorrhagic stroke[RR=0.83, 95%CI(0.57, 1.20), p=0.31] and retinopathy [RR=1.54, 95%CI(0.74, 3.23), p=0.25].

Conclusion: GLP-1RA significantly reduces the risk of ischemic stroke in type 2 diabetics with cardiovascular risk factors.

Keywords: CVOTs (cardiovascular outcome trials); GLP-1RA; T2DM; ischemic stroke; stroke.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 2* / chemically induced
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / drug therapy
Glucagon-Like Peptide-1 Receptor / agonists
Hemorrhagic Stroke* / chemically induced
Hemorrhagic Stroke* / drug therapy
Humans
Hypoglycemic Agents / therapeutic use
Ischemic Stroke*
Randomized Controlled Trials as Topic
Retinal Diseases*
Stroke* / epidemiology
Stroke* / etiology
Stroke* / prevention & control

Substances

Hypoglycemic Agents
Glucagon-Like Peptide-1 Receptor