Evidence map›Paper›PMID 25616979›Full record

Observational studyCardiovascular diabetology2015

The association of the treatment with glucagon-like peptide-1 receptor agonist exenatide or insulin with cardiovascular outcomes in patients with type 2 diabetes: a retrospective observational study.

Sanjoy K Paul, Kerenaftali Klein, David Maggs, Jennie H Best

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cardiovascular diabetology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  12. Glucagon-like peptide-1 receptor agonists as neuroprotective agents for ischemic stroke: a systematic scoping review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021
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  13. Article
  14. Observational
  15. Article
  16. Glucose Control and Weight Change Associated with Treatment with Exenatide Compared with Basal Insulin: A Retrospective Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018
    Article
  17. Review
  18. Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research.Diabetes, metabolic syndrome and obesity : targets and therapy · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sanjoy K PaulClinical Trials & Biostatistics Unit, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Brisbane, Australia. sanjoy.paul@qimrberghofer.edu.au.
Kerenaftali KleinClinical Trials & Biostatistics Unit, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Brisbane, Australia. kerenaftali.klein@qimrberghofer.edu.au.
David MaggsBristol-Myers Squibb, San Diego, CA, USA. dmaggs@gidynamics.com.
Jennie H BestUniversity of Washington, Seattle, WA, USA. bestj@uw.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate the association of treatment with glucagon-like peptide-1 (GLP-1) receptor agonist exenatide and/or insulin on macrovascular outcomes in patients with type 2 diabetes (T2DM).

methodsWe conducted a retrospective longitudinal pharmaco-epidemiological study using large ambulatory care data to evaluate the risks of heart failure (HF), myocardial infarction (MI) and stroke in established T2DM patients who received a first prescription of exenatide twice daily (EBID) or insulin between June 2005 and May 2009, with follow-up data available until December 2012. Three treatment groups were: EBID with oral antidiabetes drugs (OADs) (EBID, n = 2804), insulin with OADs (Insulin, n = 28551), and those who changed medications between EBID and insulin or had combination of EBID and insulin during follow-up, along with OADs (EBID + insulin, n = 7870). Multivariate Cox-regression models were used to evaluate the association of treatment groups with the risks of macrovascular events.

resultsDuring a median 3.5 years of follow-up, cardiovascular event rates per 1000 person-years were significantly lower for the EBID and EBID + insulin groups compared to the insulin group (HF: 4.4 and 6.1 vs. 17.9; MI: 1.1 and 1.2 vs. 2.5; stroke: 2.4 and 1.8 vs. 6.1). Patients in the EBID/EBID + insulin group had significantly reduced risk of HF, MI and stroke by 61/56%, 50/38% and 52/63% respectively, compared to patients in the insulin group (p < 0.01).

conclusionsTreatment with exenatide, with or without concomitant insulin was associated with reduced macrovascular risks compared to insulin; although inherent potential bias in epidemiological studies should be considered.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsAgedCardiovascular DiseasesCohort StudiesDiabetes Mellitus, Type 2Drug Therapy, CombinationExenatideFemaleFollow-Up StudiesHumansHypoglycemic AgentsInsulinLongitudinal StudiesMaleMiddle AgedPeptidesExenatideGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsInsulinPeptidesVenoms

Identifiers

PMID25616979
PMCPMC4314769

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.