Friday, March 24, 2023
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Clinical Associate Professor of Medicine, University of Washington, Spokane, Washington
Internist, The Frist Clinic, Nashville, Tennessee
Director, Ochsner Diabetes Clinical Research Unit, Department of Endocrinology, Diabetes and Metabolism, Associate Internal Medicine Residency Program Director, New Orleans, Louisiana
Professor of Medicine; Director, Division of Endocrinology, Diabetes & Metabolic Diseases, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Novo Nordisk; Sanofi
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As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.
Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
Clinical Associate Professor of Medicine, University of Washington, Spokane, Washington
Internist, The Frist Clinic, Nashville, Tennessee
Director, Ochsner Diabetes Clinical Research Unit, Department of Endocrinology, Diabetes and Metabolism, Associate Internal Medicine Residency Program Director, New Orleans, Louisiana
Professor of Medicine; Director, Division of Endocrinology, Diabetes & Metabolic Diseases, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Novo Nordisk; Sanofi
Served as a speaker or a member of a speakers bureau for: Merck; Novo Nordisk; Sanofi
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CME Released: 6/23/2016
Valid for credit through: 6/23/2017
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Editor's Note:
On June 13, 2016, during the American Diabetes Association 2016 Scientific Sessions, full results from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results -- A Long Term Evaluation (LEADER) trial was presented and published online in the New England Journal of Medicine by Steven Marso, MD, and colleagues. The degree of risk reduction for the 3-point major adverse cardiac event (MACE) components (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) was 13% (occurring in 608 of 4668 patients taking liraglutide) vs 14.9% (in 694 of 4672 taking placebo) (P = .01 for superiority), including a 22% lower rate of cardiovascular death (4.7 vs 6.0%, P = .007) in adults with type 2 diabetes.
In addition, on June 14, 2016, microvascular outcomes data from the EMPA-REG OUTCOME trial of empagliflozin were presented and published online in the New England Journal of Medicine by Christoph Wanner, MD, and colleagues. Treatment with empagliflozin in this population of adults with type 2 diabetes and established cardiovascular disease led to a significant 38% relative risk reduction for the composite microvascular endpoint, which included time to first initiation of laser therapy for retinopathy, vitreous hemorrhage, diabetes-related blindness, or incident or worsening nephropathy (hazard ratio [HR] = 0.62, 95% CI: 0.54, 0.70; P < .001) compared with placebo. Similar to the results for cardiovascular outcomes published in the New England Journal of Medicine in September 2015, the curves began to separate within approximately 3 months, with the benefit sustained throughout the trial. Empagliflozin also led to a significant 39% reduction in incident or worsening nephropathy (HR = 0.61; 95% CI: 0.53, 0.70; P < .001). Additional subanalyses presented during the Scientific Sessions suggest that empagliflozin reduced cardiovascular events regardless of age when starting treatment.
