The seven trials included: ELIXA (lixisenatide), LEADER (liraglutide), SUSTAIN-6 (semaglutide), EXSCEL (exenatide), Harmony Outcomes (albiglutide), REWIND (dulaglutide), and PIONEER 6 (oral semaglutide).
According to a commentary, although the primary objective of demonstrating cardiovascular safety (as mandated by US FDA) by assessing a composite outcome of MACE (adjudicated cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) has been met by all of about 20 such cardiovascular outcome trials assessing five different classes of diabetes medications reported since 2012, cardiovascular benefit has been only shown for drugs from the GLP-1 receptor agonist and sodium-glucose co-transporter-2 (SGLT2) inhibitor classes. It notes that the observed cardiovascular and other benefits identified with these two classes of drugs are considered to be largely independent from their glucose-lowering effects and probably due to pleiotropic effects. It adds that this updated meta-analysis provides novel insights into these important data, however, many questions remain to be answered, especially regarding benefit in primary prevention patients.