8007 The Effect of Glucagon-Like Peptide-1 Receptor Agonists in Reducing Major Adverse Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: A Bayesian Network Meta-Analysis

Abstract Disclosure: P.H. Romeiro: None. C.R. Silva: None. T.T. Mello: None. A. Godoi: None. L.C. Hespanhol: None. C.H. Silva: None. C.A. Balieiro: None. H.B. Ferreira: None. Background: The use of glucagon-like peptide-1 receptor agonists (GLP-1RA) is associated with a significant reduction in the incidence of major cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM), suggesting a cardioprotective role for some drugs. However, which GLP-1RA is most effective at reducing MACE is unknown. Methods: PubMed, Embase and Cochrane Central databases were searched to identify randomized controlled trials (RCTs) that compared the safety of GLP-1RA with that of placebo in patients with T2DM. Studies were included if they had a primary outcome of cardiovascular mortality, non-fatal myocardial infarction, or non-fatal stroke (outcomes required by regulatory agencies for cardiovascular safety studies in diabetes). A Bayesian network meta-analysis was conducted to estimate the relative effects between treatments using risk ratios (RR) and to rank each one according to the Surface Under the Cumulative Ranking Curve (SUCRA). Results: Nine RCTs comprising 60.080 patients with T2DM were included. The assessment of SUCRA values indicated that Semaglutide (0.74) and efpeglenatide (0.71) emerged as the most effective treatments for reducing MACE. Moreover, semaglutide demonstrated superior efficacy compared to albiglutide (0.67), oral semaglutide (0.60), liraglutide (0.51), dulaglutide (0.44), exenatide (0.33), lixisenatide (0.21), and placebo (0.20). The risk of MACE was significantly higher for lixisenatide (RR 1.0; credible interval [CrI] 0.66, 1.6), exenatide (RR 0.93; CrI 0.62, 1.4), dulaglutide (RR 0.88; CrI 0.6, 1.3), liraglutide (RR 0.86; CrI 0.58, 1.3), oral semaglutide (RR 0.79; CrI 0.48, 1.3), albiglutide (0.77; CrI 0.52, 1.2), efpeglenatide (RR 0.74; CrI 0.46, 1.2), semaglutide (RR 0.72; CrI 0.45, 1.2). Conclusion: In this network meta-analysis comparing the use of different GLP-1RA in patients with T2DM, semaglutide is the GLP-1RA with the highest likelihood of lower MACE and may be a preferable option in these patients. Lixisenatide showed the lowest likelihood for preventing MACE. Further analyses are needed to establish the effect of different GLP-1 analogues on patients with a previous history of CVD Presentation: 6/3/2024