Aims: Liraglutide has been shown to reduce cardiovascular mortality in a cardiovascular safety study, but it is not known to what extent these results will be replicated in real practice with people with diabetes treated with liraglutide in the UK. We wished to explore the likely cardiovascular benefits by modelling 10-year reduction in cardiovascular events and mortality using data from the ABCD liraglutide audit database.Methods: The UKPDS risk engine 2.0 was applied to data collected in the ABCD liraglutide audit database before and at the earliest return to clinic between 3 and 9 months after commencing liraglutide, using the 747 of 6,959 records where all factors used by the risk engine were completely recorded.Results: There were significant falls in all factors used in the UKPDS cardiovascular disease (CVD) risk assessment other than HDL cholesterol which was unchanged. The UKPDS risk engine mean±SD 10-year coronary heart disease (CHD) risk fell by 2.7±7.6% from 18.7±13.0% to 16.1±11.6% (p<0.001). The 10-year fatal CHD risk fell by 2.3±6.5% from 13.7±11.1% to 11.4±9.8% (p<0.001). The 10-year stroke risk fell by 0.3±2.8% from 7.9±8.7% to 7.6±8.3% (p=0.003). The 10-year fatal stroke risk fell by 0.1±0.7% from 1.2±1.4% to 1.1±1.3% (p=0.001).Conclusion: Starting liraglutide reduced 10-year CVD risk. These data suggest that liraglutide used in routine clinical care in 100 patients could prevent three events of CHD or stroke and save two or more lives over the next 10 years.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Background: Liraglutide may be less effective in patients with more advanced type 2 diabetes. This study from the Association of British Clinical Diabetologists Nationwide Liraglutide Audit analysed changes in HbA1c of patients after 26 weeks of treatment with liraglutide 1.2 mg, stratified according to the intensity of their background diabetes therapy, or according to their duration of diabetes.Methods: Patients using liraglutide as add-on therapy were stratified for receipt to one, two or three oral antidiabetic agents (OADs) or insulin (+/- OAD), or for diabetes duration of 0-5 years, 6-10 years, or >10 years. Changes in HbA(1c) were compared across groups after adjusting for baseline HbA(1c).Results: After exclusions to standardise comparisons, 937 patients with background diabetes treatment and 802 patients with recorded diabetes duration were analysed. Least-squares adjusted mean changes in HbA(1c) (+/- SEM) were -1.8% +/- 0.1 for 135 patients on one OAD, -1.7% +/- 0.1 for 284 patients on two OADs,-1.9% +/- 0.1 for 94 patients on three OADs (n=94) and -1.0% +/- 0.1 for 424 patients receiving insulin. HbA(1c) changes did not differ significantly between OAD groups, but all OAD groups had greater HbA(1c) reductions compared with the insulin group (all p<0.00001). Adjusted mean HbA(1c) changes were -2.0% +/- 0.1 for patients with diabetes duration 0-5 years (n=147, p<0.05 vs. longer diabetes durations), -1.6% +/- 0.1 for 6-10 years (n=256), and -1.2% +/- 0.1 for >10 years (n=399).Conclusion: The need for insulin and long diabetes duration, but not the number of OADs taken, predicted a smaller treatment response to liraglutide.