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Diabetes drug offers no benefit for heart failure patients

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A glucagon-like peptide-1 receptor agonist approved for treating diabetes is ineffective in the treatment of high-risk heart failure patients.

Researchers examined whether liraglutide – an injectable drug commonly used to treat type 2 diabetes – could improve the condition of patients with advanced heart failure by correcting defects in the energy generation that contributes to poor pump function.

“Abnormalities in the way the heart generates energy from fats and glucose contribute to risk of heart failure”

Kenneth Margulies

Despite improvements in blood glucose control, the therapy was found not to improve the clinical stability or pumping action of the heart in patients with advanced heart failure.

Dr Kenneth Margulies, from the University of Pennsylvania, presented data from the Functional Impact of GLP-1 for Heart Failure Treatment (FIGHT) study at an American Heart Association science conference in Florida.

The FIGHT study is the first multi-centre trial to evaluate the use of glucagon-like peptide-1 receptor agonists for the treatment of high-risk heart failure patients with reduced ejection fraction – a measure of the heart’s inability to pump blood.

Researchers randomised 300 diabetic and non-diabetic participants who had been admitted for heart failure within the past two weeks to receive daily liraglutide injections or a placebo.

During the six-month study, measurements of heart structure and function with echocardiography, serial assessments of subjects’ activity tolerance with six-minute walk tests, and quality of life questionnaires did not reveal any significant favourable or unfavourable effects of liraglutide.

Dr Margulies said: “The results indicate that, while liraglutide acted as intended, controlling blood sugar and promoting weight loss in diabetic participants, there was not a significant impact on heart failure in either group.

“Additional studies are required to explore whether patients with earlier stages of heart failure might benefit from liraglutide or other GLP-1 agonists,” he added.

The study authors noted that one-third of patients with heart failure also had diabetes.

“Unfortunately, the results were not what we had anticipated”

Kenneth Margulies

Dr Margulie said: “Abnormalities in the way the heart generates energy from fats and glucose, including resistance to the normal actions of insulin, have been shown to contribute to a patient’s risk of heart failure.

“Because liraglutide counters insulin resistance, and earlier pilot studies suggest that severely weakened hearts have the greatest metabolic defects and potential benefit, it seemed most appropriate to test the efficacy of liraglutide in a group of patients with advanced heart failure,” he said.

“Unfortunately, the results were not what we had anticipated,” he added.

The National Institute for Health and Care Excellence recommended in 2010 guidance that liraglutide be taken at a dose of 1.2mg once a day as a possible treatment for some people with type 2 diabetes.

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