Certain diabetes drugs have been shown to have a desirable side benefit. They protect users against what are known as major adverse cardiovascular outcomes, or MACE. These are stroke, myocardial infarction (heart attack) and fatal heart failure. A new study, however, indicates that this benefit might not extend to African-Americans.
The cardiovascular benefits of diabetes medications such as sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have been demonstrated in seven major trials, which are known as cardiovascular outcomes trials, or CVOTs. These CVOTs were conducted in centers around the world and enrolled nearly 64,000 patients. From these trials, significant MACE reductions were reported for the entire group of subjects. With one glaring exception. Among black patients, the reported overall risk ratio compared to placebos (inactive treatments) was described as “nonsignificant” for both the SGLT2 inhibitors and the GLP-1 receptor agonists.
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The researchers, however, warned against concluding that these drugs have no effect on black people with type 2 diabetes. The main reason for the caution was that the number of black subjects was small — just 5% of the total number of patients. According to Basem M. Mishriky, MD, who presented the results of the study to the most recent meeting of the American Diabetes Association, “Black or African-American patients with type 2 diabetes were not well represented in the CV safety trials and such trials were underpowered to evaluate racial differences.”
What needs to be done, then, is to institute a trial that includes only African-American patients. As Dr. Mishriky put it, “Additional studies targeting black and African-American patients are needed.” In the meantime, he added, “This is in no way to say that we shouldn’t continue to use GLP-receptor antagonists and SGLT2 inhibitors. They are great drugs.”
Want to learn more about SGLT2 inhibitors and GLP-1 agonists? Read “Diabetes Medicine: SGLT2 Inhibitors” and “Diabetes Medicine: Non-Insulin Injectable Diabetes Medicines.”
A freelance writer and editor based in the Chicago area, Gustaitis has a degree in journalism from Columbia University.