medwireNews: Participants in the REWIND trial achieved a significant reduction in total cardiovascular disease (CVD) burden with dulaglutide versus placebo, report the investigators.
REWIND included 9901 participants with type 2 diabetes, who had generally lower risk than the populations of similar trials for the same medication class; just 31.5% had established CVD.
During follow-up lasting a median of 5.4 years, there were 932 first or recurrent major adverse CV events (MACE) or non-CV deaths in participants assigned to dulaglutide and 1040 in the placebo group.
This gave rates per 1000 person–years of 35.8 versus 40.3 for an absolute reduction of 4.5 events per 1000 person–years with dulaglutide treatment, report Gilles Dagenais (Laval University, Quebec City, Canada) and colleagues.
They note that the absolute reduction was even larger for the expanded MACE outcome, which included heart failure requiring hospitalization or an urgent medical visit, unstable angina, or revascularization – in addition to nonfatal myocardial infarction or stroke and CV death.
For expanded MACE plus CV death, the rates were 67.1 versus 74.7 per 1000 person–years in the dulaglutide and placebo groups, respectively, giving an absolute reduction of 7.6 events per 1000 person–years with active treatment.
“Our study supports the clinical implication of assessing all CV events or deaths in addition to the first manifestation of the primary outcome of randomized trials to capture the impact of the pharmacological intervention on the burden of disease,” concludes the team in Cardiovascular Diabetology.
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