Table 2.
DM | Non-DM | |
---|---|---|
CKD prevention | GLP-1 RA reduce albuminuria and modify risk factors and reduction of a broad kidney composite outcome by 17%. Recommended in CKD. | No human trials yet. CVOT in T2DM suggest renoprotective effects with corrected for glycaemic control. |
| ||
CVD prevention | GLP-1 RA reduce MACE in CVOT by 14% and a slightly lower risk of hospitalization for HF by 9%, reduction in all-cause mortality by 12%. | No direct trials yet. GLP-1 RAs for 7 days make a mild improvement of left ventricular function in patients with ST-segment elevation myocardial infarction (STEMI) as well as non-STEMI. |
| ||
Dyslipidaemia, hypertension, and nonalcoholic fatty liver disease (NAFLD) prevention | No direct trials for GLP-1 RA on hypertension, NAFLD, and dyslipidaemia. CVOTs showed reduction of BP and dyslipidaemia, consistent with reduced all-cause mortality |
Liraglutide vs. placebo in obese patients, BP, and fasting lipids lower with liraglutide. Liraglutide vs. placebo in obese patients, more frequent resolution of NAFLD, and less progression to fibrosis. Meta-analysis shows GLP-1 RA reduce ALT and improve NAFLD. |
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Prevention of PCOS, metabolic, and cardiovascular complications | GLP-1 RA improve insulin sensitivity and weight control, and therefore hyperandrogenism and metabolic complications in PCOS. Exenatide vs. metformin, exenatide induce remission of 56% of prediabetes in PCOS. |
Open-label trial liraglutide, reduce weight. RCT liraglutide vs. metformin, liraglutide reduce BMI. RCT exenatide vs. metformin, exenatide lower BMI. Open-label trial exenatide, BMI -1 to -3.1. Exenatide vs. metformin, exenatide increase fertility, frequency and regularity of periods, and ovulatory rate. |
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Obesity & overweight prevention | GLP-1 RAs proven to induce weight loss and improve glycaemic control. Liraglutide body weight loss of 5.8% Semaglutide body weight loss of 6.9-9.6% |
Pharmacotherapy for BMI > 30 or overweight with complications. RCT diet+exercise+/-liraglutide, found BMI -3+/-2.6 with liraglutide. RCT liraglutide vs. semaglutide vs. placebo, found 7.8% LOW with liraglutide, and 11-14% LOW with semaglutide. |
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Prevention of perioperative and postoperative complications of bariatric surgery | GLP-1 RA known to improve glycaemic control and treat the persistent/recurrent T2DM postbariatric surgery. No human trials yet investigating role of GLP-1 RA in success of bariatric surgery. |
No human trials yet. GLP-1 rises after bariatric surgery and prevent the onset of T2DM postbariatric surgery. |
LOW: loss of weight.