ADLYXIN^® (lixisenatide) [prescribing information]. Sanofi-Aventis U.S. LLC, A Sanofi Company. Approved 2016. Revised July 2016.
Anderson JE, Thieu VT, Boye KS, et al. Dulaglutide in the treatment of adult type 2 diabetes: a perspective for primary care providers. Postgrad Med. 2016;128:810-821.
Aroda VR, Ahmann A, Cariou B, et al. Comparative efficacy, safety, and cardiovascular outcomes with once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes: Insights from the SUSTAIN 1-7 trials. Diabetes Metab. 2019;45:409-418.
Aroda VR, Rosenstock J, Terauchi Y, et al; PIONEER 1 Investigators. PIONEER 1: randomized clinical trial of the efficacy and safety of oral semaglutide monotherapy in comparison with placebo in patients with type 2 diabetes. Diabetes Care. 2019;42:1724-1732.
Ayer J, Charakida M, Deanfield JE, et al. Lifetime risk: childhood obesity and cardiovascular risk. Eur Heart J. 2015;36:1371-1376.
Brazilian Ministry of Health website. Vigitel Brasil 2018 Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. 2019. Accessed November 12, 2020. https://portalarquivos2.saude.gov.br/images/pdf/2019/julho/25/vigitel-brasil-2018.pdf
Buse JB, Wexler DJ, Tsapas A, et al. 2019 Update to: management of hyperglycemia in type 2 diabetes, 2018. a consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Correction in: Diabetes Care. 2020 Jul;43:1670. Diabetes Care. 2020;43:487-493.
Cercato C, Fonseca FA. Cardiovascular risk and obesity. Diabetol Metab Syndr. 2019;11:74.
ClinicalTrials.gov. A study to evaluate cardiovascular outcomes in patients with type 2 diabetes treated with ITCA 650. Updated January 27, 2017. Accessed November 11, 2020. https://www.clinicaltrials.gov/ct2/show/NCT01455896
Cosentino F, Grant PJ, Aboyans V, et al; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41:255-323.
Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabetes Care. 2010;33:1389-1394.
Donnelly D. The structure and function of the glucagon-like peptide-1 receptor and its ligands. Br J Pharmacol. 2012;166:27-41.
Drucker DJ, Buse JB, Taylor K, et al; DURATION-1 Study Group. Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non-inferiority study. Lancet. 2008;372:1240-1250.
Drucker DJ. The cardiovascular biology of glucagon-like peptide-1. Cell Metab. 2016;24:15-30.
Fineman M, Flanagan S, Taylor K, et al. Pharmacokinetics and pharmacodynamics of exenatide extended-release after single and multiple dosing. Clin Pharmacokinet. 2011;50:65-74.
Frier BM, Schernthaner G, Heller SR. Hypoglycemia and cardiovascular risks. Diabetes Care. 2011;34 Suppl 2(Suppl 2):S132-S137.
Geiser JS, Heathman MA, Cui X, et al. Clinical pharmacokinetics of dulaglutide in patients with type 2 diabetes: analyses of data from clinical trials. Clin Pharmacokinet. 2016;55:625-634.
Gerstein HC, Colhoun HM, Dagenais GR, et al; REWIND Investigators. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394:121-130.
Ghosh-Swaby OR, Goodman SG, Leiter LA, Chet al. Glucose-lowering drugs or strategies, atherosclerotic cardiovascular events, and heart failure in people with or at risk of type 2 diabetes: an updated systematic review and meta-analysis of randomised cardiovascular outcome trials. Lancet Diabetes Endocrinol. 2020;8:418-435.
Hermansen K, Bækdal TA, Düring M, et al. Liraglutide suppresses postprandial triglyceride and apolipoprotein B48 elevations after a fat-rich meal in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, cross-over trial. Diabetes Obes Metab. 2013;15:1040-1048.
Hernandez AF, Green JB, Janmohamed S, et al; Harmony Outcomes Committees and Investigators. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. Lancet. 2018;392:1519-1529.
Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb. 2018;25:771-782.
Holman RR, Bethel MA, Mentz RJ, et al; EXSCEL Study Group. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017;377:1228-1239.
Husain M, Birkenfeld AL, Donsmark M, et al; PIONEER 6 Investigators. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2019;381:841-851.
Kapitza C, Nosek L, Jensen L, et al. Semaglutide, a once-weekly human GLP-1 analog, does not reduce the bioavailability of the combined oral contraceptive, ethinylestradiol/levonorgestrel. J Clin Pharmacol. 2015;55:497-504.
Keller G, Zimmer G, Mall G, et al. Nephron number in patients with primary hypertension. N Engl J Med. 2003;348:101-108.
Khan SS, Ning H, Wilkins JT, et al. Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity. JAMA Cardiol. 2018;3:280-287.
Knop FK, Brønden A, Vilsbøll T. Exenatide: pharmacokinetics, clinical use, and future directions. Expert Opin Pharmacother. 2017;18:555-571.
Li G, Zhang P, Wang J, et al. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study. Lancet Diabetes Endocrinol. 2014;2:474-80.
Libby P, Plutzky J. Diabetic macrovascular disease: the glucose paradox? Circulation. 2002;106:2760-2763.
Look AHEAD Research Group, Gregg EW, Jakicic JM, et al. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post-hoc analysis of the Look AHEAD randomised clinical trial. Lancet Diabetes Endocrinol. 2016;4:913-921.
Lyseng-Williamson KA. Glucagon-like peptide-1 receptor analogues in type 2 diabetes: their use and differential features. Clin Drug Investig. 2019;39:805-819. Erratum in: Clin Drug Investig. 2019 Aug 17; Erratum in: Clin Drug Investig. 2019 Sep 12; Erratum in: Clin Drug Investig. 2020 Mar;40:291.
Magkos F, Fraterrigo G, Yoshino J, et al. Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity. Cell Metab. 2016;23:591-601.
Maggioni AP, Caterson ID, Urso R, et al. Relation between weight loss and causes of death in patients with cardiovascular disease: finding from the SCOUT trial. J Cardiovasc Med (Hagerstown). 2017;18:144-151.
Marbury TC, Flint A, Jacobsen JB, et al. Pharmacokinetics and Tolerability of a single dose of semaglutide, a human glucagon-like peptide-1 analog, in subjects with and without renal impairment. Clin Pharmacokinet. 2017;56:1381-1390.
Marso SP, Bain SC, Consoli A, et al; SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834-1844.
Marso SP, Daniels GH, Brown-Frandsen K, et al; LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311-322.
Marso SP, Holst AG, Vilsbøll T. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2017;376:891-892.
Mosenzon O, Blicher TM, Rosenlund S, et al; PIONEER 5 Investigators. Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2019;7:515-527. Erratum in: Lancet Diabetes Endocrinol. 2019 Sep;7(9):e21.
Muskiet MHA, Tonneijck L, Smits MM, et al. GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetes. Nat Rev Nephrol. 2017;13:605-628.
Nauck M, Rizzo M, Johnson A, et al. Once-daily liraglutide versus lixisenatide as add-on to metformin in type 2 diabetes: a 26-week randomized controlled clinical trial. Diabetes Care. 2016;39:1501-1509.
Nauck MA, Meier JJ. Management of endocrine disease: are all GLP-1 agonists equal in the treatment of type 2 diabetes? Eur J Endocrinol. 2019;181:R211-R234.
NCBI. PubChem Compound Summary for CID 90472060, Lixisenatide. Updated December 5, 2020. Accessed December 11, 2020. https://pubchem.ncbi.nlm.nih.gov/compound/Lixisenatide
NCBI. PubChem Compound Summary for CID 16134956, Liraglutide. Updated December 5, 2020. Accessed December 11, 2020. https://pubchem.ncbi.nlm.nih.gov/compound/Liraglutide
Okazaki S, Yokoyama T, Miyauchi K, et al. Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation. 2004;110:1061-1068.
Okerson T, Chilton RJ. The cardiovascular effects of GLP-1 receptor agonists. Cardiovasc Ther. 2012;30:e146-e155.
Overgaard RV, Delff PH, Petri KCC, et al. Population pharmacokinetics of semaglutide for type 2 diabetes. Diabetes Ther. 2019;10:649-662.
Pepine CJ. The effects of angiotensin-converting enzyme inhibition on endothelial dysfunction: potential role in myocardial ischemia. Am J Cardiol. 1998;82:23S-27S.
Pfeffer MA, Claggett B, Diaz R, et al; ELIXA Investigators. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med. 2015;373:2247-2257.
Pieber TR, Bode B, Mertens A, et al; PIONEER 7 investigators. Efficacy and safety of oral semaglutide with flexible dose adjustment versus sitagliptin in type 2 diabetes (PIONEER 7): a multicentre, open-label, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2019;7:528-539. Erratum in: Lancet Diabetes Endocrinol. 2019 Sep;7:e21.
Poulter NR, Mann J, Fonseca V, et al; on behalf of the LEADER Trial Steering Committee and Investigators. Liraglutide reduces major cardiovascular events in patients with chronic kidney disease: results from the Leader Trial. Circulation. 2017;136:A15035.
Pratley R, Amod A, Hoff ST, et al; PIONEER 4 investigators. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. Lancet. 2019;394:39-50. Erratum in: Lancet. 2019 Jul 6;394:e1.
Rakipovski G, Rolin B, Nøhr J, et al. The GLP-1 analogs liraglutide and semaglutide reduce atherosclerosis in ApoE-/- and LDLr-/- Mice by a mechanism that includes inflammatory pathways. JACC Basic Transl Sci. 2018;3:844-857.
Reid TS. Practical use of glucagon-like peptide-1 receptor agonist therapy in primary care. Clin Diabetes. 2013;31:148-157.
Rodbard HW, Rosenstock J, Canani LH, et al; PIONEER 2 Investigators. Oral Semaglutide versus empagliflozin in patients with type 2 diabetes uncontrolled on metformin: the PIONEER 2 trial. Diabetes Care. 2019;42:2272-2281.
Rosenstock J, Allison D, Birkenfeld AL, et al; PIONEER 3 Investigators. Effect of Additional oral semaglutide vs sitagliptin on glycated hemoglobin in adults with type 2 diabetes uncontrolled with metformin alone or with sulfonylurea: the PIONEER 3 randomized clinical trial. JAMA. 2019;321:1466-1480.
Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340:115-126.
Ryan D, Acosta A. GLP-1 receptor agonists: Nonglycemic clinical effects in weight loss and beyond. Obesity (Silver Spring). 2015;23:1119-1129.
Sena CM, Pereira AM, Seiça R. Endothelial dysfunction - a major mediator of diabetic vascular disease. Biochim Biophys Acta. 2013;1832:2216-2231.
Shah AD, Langenberg C, Rapsomaniki E, et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1·9 million people. Lancet Diabetes Endocrinol. 2015;3:105-113.
Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 1995;92:1355-1374.
TRULICITY^® (dulaglutide) [prescribing information]. Eli Lilly and Company. Approved 2014. Revised January 2017.
VICTOZA® (liraglutide) [prescribing information]. Novo Nordisk Inc. Approved 2010. Revised August 2017.
Vykoukal D, Davies MG. Vascular biology of metabolic syndrome. J Vasc Surg. 2011;54:819-831.
Xiao C, Dash S, Morgantini C, et al. New and emerging regulators of intestinal lipoprotein secretion. Atherosclerosis. 2014;233:608-615.
Zinman B, Aroda VR, Buse JB, et al; PIONEER 8 Investigators. Efficacy, Safety, and tolerability of oral semaglutide versus placebo added to insulin with or without metformin in patients with type 2 diabetes: The PIONEER 8 Trial. Diabetes Care. 2019;42:2262-2271.

Tratamento do diabetes mellitus tipo 2: otimização da abordagem após a introdução de agonistas do receptor de GLP-1

Authors: Luciano Giacaglia, MD; Álvaro Avezum, MD, PhD, FESC, FACC; Otávio Rizzi Coelho, MD, PhD, FESC, FACC; José Francisco Kerr Saraiva, MD, PHD, FACC, FESC; Francisco Fonseca, MD, PhD, FACC, FESC; José Rocha-Faria Neto, MD Faculty and Disclosures

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Postado em 16/12/20

Esta atividade destina-se a cardiologistas, clínicos gerais, e especialistas em saúde pública e medicina preventiva.

Após a conclusão desta atividade os participantes terão:

Maior conhecimento sobre
- a relação entre o crescimento da carga global de obesidade e a doença cardiovascular no Brasil
- a descrição de um novo grupo terapêutico para o manejo do diabetes no que diz respeito ao mecanismo de ação, indicações e manejo no geral
Demonstrar maior confiança na sua capacidade de
- identificar estratégicas padrão atuais para alcançar um monitoramento contínuo adequado da glicose juntamente com o tratamento farmacológico adequado

Conteúdo da Atividade

Para completar a atividade, é favor assistir a todas as sessões

O tratamento do diabetes mellitus tipo 2 após a introdução dos agonistas do receptor de GLP-1

Acompanhe o Dr. Luciano Giacaglia na apresentação sobre o tratamento do diabetes após a introdução de agonistas do receptor de GLP-1.
Luciano Giacaglia, MD

Eficácia e segurança dos agonistas do receptor de GLP-1 de primeira geração: liraglutida, exenatida e lixisenatida

Acompanhe o Dr. Otávio Rizzi Coelho na abordagem sobre a eficácia e segurança dos agonistas do receptor de GLP-1 de primeira geração.
Otávio Rizzi Coelho MD, PhD, FESC, FACC

Eficácia e segurança dos agonistas do receptor de GLP-1 de segunda geração: semaglutida e dulaglutida

Acompanhe o Dr. José Rocha-Faria Neto na abordagem sobre a eficácia e segurança dos agonistas do receptor de GLP-1 de segunda geração.
José Rocha-Faria Neto, MD, PhD

A importância da redução de peso e da inflamação no tratamento do diabetes tipo 2

Acompanhe o Dr. Kerr Saraiva nesta discussão sobre o papel da redução de peso e da inflamação no diabetes tipo 2.
José Francisco Kerr Saraiva, MD, PHD, FACC, FESC

Os efeitos cardiovasculares dos agonistas do receptor de GLP-1

Acompanhe o Dr. Fonseca nesta discussão sobre os efeitos cardiovasculares dos agonistas do receptor de GLP-1
Francisco Fonseca, MD, PhD, FACC, FESC

Eficácia e segurança da nova semaglutida oral

Acompanhe o Dr. Álvaro Avezum na abordagem sobre os dados de eficácia e segurança disponíveis sobre a semaglutida oral
Álvaro Avezum, MD, PhD, FESC, FACC

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O tratamento do diabetes mellitus tipo 2 após a introdução dos agonistas do receptor de GLP-1

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The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been authorized by the European Medicines Agency for use in Europe, off-label uses of authorized products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculdade

Luciano Giacaglia, MD

Álvaro Avezum, MD, PhD, FESC, FACC

Otávio Rizzi Coelho, MD, PhD, FESC, FACC

José Francisco Kerr Saraiva, MD, PHD, FACC, FESC

Francisco Fonseca, MD, PhD, FACC, FESC

José Rocha-Faria Neto, MD, PhD

Editores

Rita Moreira da Silva, PharmD, PhD

Revisor de Conteúdos

Esther Nyarko, PharmD

Revisor por pares

Tratamento do diabetes mellitus tipo 2: otimização da abordagem após a introdução de agonistas do receptor de GLP-1

Conteúdo da Atividade