GLP1 Receptor Agonists reduce VTE risk in Type 2 Diabetes, claims research

Glucagon-like peptide 1 receptor
agonists (GLP1-RA) are antihyperglycemic agents used for the treatment of type
2 diabetes mellitus (T2DM) which is a global pandemic. They are also prescribed
for weight loss in obese patients. Research shows a consistent cardiovascular
benefit with the use of GLP1-RA in T2DM. Previous studies have shown that
GLP1-RA may reduce the thromboxane-induced platelet activation. As obesity is one
of the risk factors for venous thromboembolism (VTE) researchers hypothesized
that GLP1-RA use may reduce the risk of VTE.

A retrospective, propensity
score-matched multicenter database analysis was carried out using the TriNetX
Analytics Network. Individuals with T2DM were taken for the study as diabetics
use GLP1-RA. Individuals using oral anticoagulation, prior VTE, or a history of
atrial fibrillation were excluded from the study.

Comparisons were done between patients
who received GLP1-RA with those who received Dipeptidyl Peptidase-4 (DPP-4)
inhibitors for achieving glycemic control. A subgroup analysis was also
performed stratified by the presence of obesity. An individual was considered
obese if they have a body mass index (BMI) 30 kg/m². The primary
outcome was incidence rate per 1000-patient years of all VTE at 1-year after
the index date of first initiation of GLP1-RA or DPP-4 inhibitors. pulmonary
embolism (PE) and deep venous thrombosis (DVT) measured individually were the
secondary outcomes.

propensity-matching was done to
patients (1:1) taking GLP1-RA with those on DPP-4 inhibitors based on
predetermined clinical variables, including age, sex, race, BMI, hemoglobin
A1c, use of other anti-diabetic agents including metformin and insulin, and
underlying comorbidities. Charleston Comorbidity index was used for the
propensity matching. a subgroup analysis was carried out as a secondary
analysis stratified by the presence of obesity.

Findings:

• About 6,56,588 eligible patients who had T2DM were
  identified of whom 366,369 received GLP1-RA and 290,219 received DPP-4
  inhibitors, respectively.
• Among patients with known BMI data, 62% of the
  patients were classified as obese with a BMI of 30kg/m².
• Two cohorts ach having 168,428 patients were included
  in the final analysis who received GLP1-RA and DPP-4 inhibitors after
  propensity-score matching.
• Both cohorts were well balanced for
  demographics, hemoglobin A1c, BMI, other anti-diabetic drugs, and preexisting
  comorbidities.
• The mean HbA1c were 8.3 ± 2.0 and 8.3 ± 2.0,
  and the mean BMI was 33.3 ± 7.4 and 32.4 ± 7.1 for patients on GLP1-RA and
  DPP-4 inhibitors, respectively.
• The incidence of VTE was 11.0 events per 1000
  patient-years in the GLP1-RA cohort vs. 12.9 in the DPP-4 inhibitor cohort indicating
  that GLP1-RA decreased the VTE.
• Patients who received GLP1-RA had an 18% lower
  risk of VTE than those who received DPP-4 inhibitors.
• Similarly, patients who received GLP1-RA had a
  lower risk of PE and DVT than those on DPP-4 inhibitors.
• In the subgroup analysis, similar differences in
  VTE rates were observed in patients with obesity and without obesity.

Thus, the study concluded that
GLP1-RA reduces the risk of VTE and has a potential beyond glycemic control in
individuals with obesity and type 2 diabetes.

Further reading:

Glucagon-like Peptide 1
Receptor Agonists Reduce the Risk of Venous Thromboembolism in Patients with
Diabetes Irrespective of Obesity: A Propensity Score-Matched Multicenter
Database Analysis. Oral and Poster Abstracts. Poster No.701.