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VIDEO: Discussion on diabetes drugs, CV outcomes fruitful
PHILADELPHIA — In this Endocrine Today video perspective, Deepak L. Bhatt, MD, MPH, from Brigham and Women‘s Hospital and Harvard Medical School, discusses a session from the Heart and Diabetes Medical Conference on diabetes drugs and cardiovascular outcome trials, for which he was co-chair.
According to Bhatt, this area has been of great interest ever since the FDA mandate to perform CV outcome trials as a condition of approving diabetes drugs.
“This led to a series of trials that initially evaluate agents such as the DPP-IV inhibitors showing noninferiority for CV outcomes, which at the time was a big conceptual advance showing that the diabetes drugs that we were using — in that case, DPP-IV inhibitors —weren't increasing the rates of myocardial infarction.”
Bhatt said data surrounding SGLT2 inhibitors provided very interesting material for discussion.
“Oral agents that have now been shown to improve CV outcomes and maybe some benefits with respect to atherosclerotic-type outcomes, but in particular where those agents have been really exciting has been in heart failure,” he said. “Not causing it, not being neutral, but actually preventing a hospitalization for HF by a large amount.”
The outcomes of both the EMPA-REG Outcome and CANVAS trials led to an insightful discussion on trial design, trial population and the drugs themselves, Bhatt said.
“It really spurred a discussion among the panel about what the implications of these trials are for clinical practice — a discussion that really we can’t talk about class effects so much, we really need to talk about drugs because of some differences potentially in that HF signal among DPP-IV inhibitors,” Bhatt said. “I think the audience got a lot of insight into this evolving field of CV outcomes trials and diabetes.”