Systematic Review of Glucagon-Like Peptide One Receptor Agonist Liraglutide of Subjects with Heart Failure with Reduced Left Ventricular Ejection Fraction

Hamad F 1 , Elnour AA 2 , Elamin A 3 , Mohamed S 4 , Yousif I 5 , Don J 6 Show all authors , Abdi S 7 , Al Amoodi A 8 , Fathelrahman AI 9 , Gnana K 2 , Alanzi F 10 , Abubakar AB 11 , Magboul SM 12 , Ahmed SA 13 , Sadeq A 14

Affiliations 

  • 1 Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
  • 2 Al Ain University, Abu Dhabi, United Arab Emirates
  • 3 Medical Laboratory Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
  • 4 Clinical Pharmacy, College of Pharmacy, Riyadh Elm University Riyadh, Saudi Arabia
  • 5 Clinical Pharmacist, Omdurman Islamic University, Omdurman, Sudan
  • 6 College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
  • 7 Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
  • 8 Ambulatory Healthcare Services, Academic Affairs, Abu Dhabi Health Services (SEHA), United Arab Emirates
  • 9 Department of Clinical Pharmacy, College of Pharmacy, Taif University, Saudi Arabia
  • 10 Physical Therapy Department, College of Applied Medical Sciences, Jouf-University, Saudi Arabia
  • 11 Department of Medical Imaging and Radiation Sciences, Monash University, Malaysia
  • 12 College of Pharmacy, Khartoum University, Khartoum, Sudan
  • 13 MySmile Dental Clinic, Dubai, United Arab Emirates
  • 14 Program of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
Curr Diabetes Rev, 2021;17(3):280-292.
PMID: 32867644 DOI: 10.2174/1573399816999200821164129

Abstract

BACKGROUND: The major cardiovascular outcome trials on glucagon-like peptide one-receptor agonists have examined its effect on hospitalization of subjects with heart failure; however, very limited trials have been conducted on subjects with reduced left ventricular ejection fraction (r- LVEF) as a primary outcome.

OBJECTIVE: We have conducted a systematic review of two major (FIGHT and LIVE) placebo-controlled trials of liraglutide and its clinical effect on the ejection fraction of subjects with heart failure.

METHODS: Medline data was retrieved for trials involving liraglutide from 2012 to 2020. The inclusion criteria for trials were: subjects with or without type 2 diabetes mellitus (T2DM), subjects with heart failure with rLVEF, major trials (phase II or III) on liraglutide, trials included liraglutide with defined efficacy primary outcome of patients with heart failure with rLVEF. The search was limited to the English language, whereby two trials [FIGHT and LIVE] had been included and two trials were excluded due to different primary outcomes. Participants (541) had been randomized for either liraglutide or placebo for 24 weeks.

RESULTS: In the FIGHT trial the primary intention-to-treat, sensitivity, and diabetes subgroup analyses have shown no significant between-group difference in the global rank scores (mean rank of 146 in the liraglutide group versus 156 in the placebo group; Wilcoxon rank-sum P=.31), number of deaths, re-hospitalizations for heart failure, or the composite of death or change in NT-pro BNP level (P= .94). In the LIVE trial, the change in the left ventricular ejection fraction (LVEF) from baseline to week 24 was not significantly different between treatment groups. The overall discontinuation rate of liraglutide was high in the FIGHT trial (29%, 86) as compared to that in the LIVE trial (11.6%, 28).

CONCLUSION: FIGHT and LIVE trials have demonstrated that liraglutide use in subjects with heart failure and rLVEF was implicated with an increased adverse risk of heart failure-related outcomes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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