Diabetes Q&A

ACC Releases New Guidance on Use of SGLT2 Inhibitors, GLP-1RAs

The American College of Cardiology has released new guidance on the use of therapies for cardiovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease.

 

“Despite major therapeutic advances leading to improved outcomes over the past 2 decades, cardiovascular (CV) disease remains the leading cause of morbidity and mortality in patients with type 2 diabetes (T2D) …Accordingly, the development of treatment strategies to improve CV outcomes in this vulnerable patient population remains a major priority.”

 

In response to the introduction of certain sodium-glucose cotransporter 2 (SGLT 2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1Ras) that reduce the risk of major adverse cardiovascular events, the authors of the guidance sought to summarize key evidence from recent studies and provide practical guidance on the use of specific glucose-lowering agents for the reduction of CV risk in patients with T2D.

 

They recommend that, following discussion with the patient, clinicians should consider adding SGLT2 inhibitors and GLP-1RAs to the treatment regimen of patients with T2D and atherosclerotic cardiovascular disease (ASCVD) to lower CV risk.

 

“We have highlighted the potential benefits and risks associated with these novel therapies and have sought to provide a context for the rational utilization of these medications. The evidence for specific agents in these classes is still emerging, and other cardiovascular outcomes trials in T2D are currently underway. As such, this area of care for affected patients is likely to continue evolving rapidly. We anticipate that the algorithms proposed here will change as new evidence emerges, but that the overarching goal of improving CV outcomes in patients with T2D and clinical ASCVD will remain consistent.”

 

—Michael Potts

 

Reference:

Das SR, Everett BM, Birtcher KK, et al. 2018 ACC expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease [published online November 27, 2018]. JACC. doi: 10.1016/j.jacc.2018.09.020.