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Recommended reading – key published papers from 2017

Recommended reading – key published papers from 2017
  • Cardiometabolic
  • Diabetes

Recommended reading – key published papers from 2017 as chosen by our Scientific Committee Members,
Professor Chaicharn Deerochanawong and Professor Ruy Lyra

2017 has been a rich and diverse year in terms of diabetes research and publications. We asked our Scientific Committee Members for Manage Diabetes Online, Professor Ruy Lyra from Brazil and Professor Chaicharn Deerochanawong from Thailand to highlight the papers from 2017 which, in their opinion, were the key papers of the year – those that have made the most impact on the scientific community.

These papers are in no particular order


Holman RR, Bethel MA, Mentz RJ, et al. EXSCEL Study Group. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2017 Sep 28;377(13):1228-39. doi: 10.1056/NEJMoa1612917.

In this study, patients with type 2 diabetes (T2D), with or without previous cardiovascular disease, were randomized to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The authors concluded that among patients with T2D with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo.

Schnell O, Rydén L, Standl E, Ceriello A. D&CVD EASD Study Group. Updates on cardiovascular outcome trials in diabetes. Cardiovasc Diabetol 2017 Oct 11;16(1):128. doi: 10.1186/s12933-017-0610-y.

In this review, the authors summarize the results of the 2017 DEVOTE, CANVAS, EXSCEL and ACE trials that tested the cardiovascular safety of the insulins degludec, canagliflozin, once-weekly exenatide and acarbose. They provide context on these results by comparing them with earlier trials of glucose-lowering drugs and give an outlook on what to expect in coming years.

Dalsgaard NB, Vilsbøll T, Knop FK. Effects of glucagon-like peptide-1 receptor agonists on cardiovascular risk factors: A narrative review of head-to-head comparisons. Diabetes Obes Metab 2017 Oct 12. doi: 10.1111/dom.13128.

These descriptive data indicate that individual GLP-1RAs affect cardiovascular risk factors differently, potentially because of their individual pharmacokinetics and/or size. Short-acting GLP-1RAs appeared to result in smaller changes in systolic blood pressure and total cholesterol compared with continuous-acting treatments, while large GLP-1RAs had a reduced effect on body weight compared with small GLP-1RAs. For glycaemic control, short-acting GLP-1RAs had a greater impact on postprandial glucose levels versus continuous-acting GLP-1RAs, but for fasting plasma glucose levels and HbA1c, continuous-acting treatments had the greater effect. No differentiating trends were obvious in heart rate data. These diverse actions of GLP-1RAs on cardiovascular risk factors should aid individualized patient treatment.

Ridker PM, Everett BM, Thuren T, et al. CANTOS Trial Group. Anti-inflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017 Sep 21;377(12):1119-31. DOI: 10.1056/NEJMoa1707914

This randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involved 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of ≥2 mg/L. Canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering.

Heymsfield SB, Wadden TA. Mechanisms, pathophysiology, and management of obesity.  N Engl J Med 2017 Jan 19;376:254-66. DOI: 10.1056/NEJMra1514009

This is one of the best update reviews of the mechanisms, pathophysiology and management of obesity.

Marshall S. 60 years of metformin use: a glance at the past and a look to the future.  Diabetologia 2017;60:1560-65. DOI 10.1007/s00125-017-4343-y

This review demonstrates how a drug that could easily have been lost and forgotten following a turbulent start, has not only become a leading treatment of T2D, but also shows promise for the treatment of type 1 diabetes, diabetes in pregnancy, polycystic ovary syndrome, ageing and cancer. However, a common theme is that robust evidence is lacking for metformin use in many of these conditions, threatening the chance of this drug remaining in the top spot, whilst other newer glucose-lowering therapies are quickly being introduced to the market. Nonetheless, at present, metformin remains as one of ‘the most efficacious, safe and cost-effective medicines for priority conditions’.

Sabatine MS, Giugliano RP, Keech AC, et al. FOURIER Steering Committee and Investigators. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017 May 4;376(18):1713-22. doi: 10.1056/NEJMoa1615664.

Inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol/L) and reduced the risk of cardiovascular events. These findings show that patients with atherosclerotic cardiovascular disease benefit from lowering of LDL cholesterol levels below current targets.




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