Novel Antidiabetic Therapies and Cardiovascular Risk Reduction: The Role of the Noninferiority Trial

Cardiol Clin. 2019 Aug;37(3):335-343. doi: 10.1016/j.ccl.2019.04.007. Epub 2019 May 8.

Abstract

Diabetes is a major risk factor for cardiovascular disease, yet until now treatments for diabetes had only a modest impact on cardiovascular events. New interventions for patients with type 2 diabetes mellitus (oral empagliflozin and injectable liraglutide) are associated with unprecedented reductions in composite cardiovascular outcomes that seem disproportionate to the impact on glycated hemoglobin. This review examines in detail the recent trials that arrived at these conclusions, limitations of these studies, and how these outcomes may influence patient management in the future.

Keywords: Cardiovascular risk; Empagliflozin; Liraglutide; Mortality; Noninferiority trial.

Publication types

  • Review

MeSH terms

  • Benzhydryl Compounds / therapeutic use*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Glucosides / therapeutic use*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Liraglutide / therapeutic use*
  • Risk Factors
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use

Substances

  • Benzhydryl Compounds
  • Glucosides
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • Liraglutide
  • empagliflozin