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03-02-2010 | Cardiology | Article

Positive impact of exenatide on BP, weight ‘warrants further study’

Abstract

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MedWire News: The diabetes drug exenatide is associated with reductions in systolic blood pressure (BP) and body weight, a randomized clinical trial has found.

These additional effects of exenatide, a glucagon-like peptide-1 agonist used to treat Type 2 diabetes mellitus, are interesting and warrant further study, write James Malone (Eli Lilly and Company, Indianapolis, USA) and colleagues in the journal Cardiovascular Diabetology.

Malone’s team studied the impact of exenatide on heart rate (HR) and BP in 54 patients with well-controlled Type 2 diabetes taking metformin and/or a thiazolidinedione. They were randomly assigned to receive exenatide 5–10 µg twice daily or matching placebo for 12 weeks, on top of existing therapy.

At the end of the study, HR had risen by 1.5 beats per minute (bpm), on average, in the exenatide group and fallen by 0.1 bpm in the placebo group. Neither change was statistically significant, and there was no difference between the treatment groups.

Interestingly, several measures of BP fell more with exenatide than with placebo, including mean 24-hour, daytime, and nighttime systolic BP (treatment differences of 3.5, 2.9, and 5.6 mmHg, respectively).

Exenatide was also associated with greater reductions in body weight and glycated hemoglobin over the study course compared with placebo. Mild-to-moderate nausea was the most frequently reported adverse event in exenatide-treated patients; there were no episodes of severe hypoglycemia in either group.

Malone’s team says that the effects observed in this study are consistent with larger, long-term trials in finding no apparent cardiovascular safety concerns and suggesting some improvement in systolic BP.

Noting that even small decreases in systolic BP are associated with a reduction in major cardiovascular events and cardiovascular mortality in hypertensive subjects with diabetes, the authors conclude: “Larger subsequent studies should clarify the effect of exenatide on trends in cardiovascular markers, including weight loss and systolic BP, and explore the potential for lowering overall risk.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Joanna Lyford

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