Researchers from Korea and Germany have identified the therapeutic effects of Glucagon-like Peptide-1 receptor (GLP-1R) agonist in preventing cardiovascular troubles, Seoul National University Hospital (SNUH) said Tuesday.
GLP-1R, expressed in multiple cells and tissues, mediates pleiotropic effects on organs not involved in glucose regulation. It is a new concept of diabetes treatment that lowers blood sugar by inducing an intestinal hormone elevation, which improves the function of the pancreas.
The treatment has recently drawn attention from academic circles after proving that the medication can reduce cardiovascular disease and mortality in diabetic patients.
According to a multicenter study in 2016, 13 percent of patients with cardiovascular occurrences such as myocardial infarction and stroke had a 22 percent reduction in mortality after treatment with liraglutide, a GLP-1R. Another drug, semaglutide, also reduced the incidence of multiple cardiovascular troubles by 26 percent. However, regarding lixisenatide and exenatide, once-weekly doses of the same series of GLP-1R, the drug failed to reduce the incidence of cardiovascular disease.
The results have stirred up a controversy over whether or not the effects of GLP-1R are an overall class effect.
The research team, led by Professor Lim Soo of the department of endocrinology at SNUH and Professor Michael Nauck of the department of medicine at the St Josef-Hospital, analyzed various GLP-1R researches to resolve the controversy.
As a result, the team identified that although GLP-1R showed a positive overall therapeutic effect, patients had to take the appropriate dosage for an adequate duration to reap the benefits of the drug.
Also, the drug showed therapeutic effects such as pancreas protection, cardiovascular function, anti-arteriosclerosis effect, anti-inflammatory effect and other musculoskeletal effects. Concerning side effects, although the incidence was very low, the team confirmed the possibility of pancreatitis, gallbladder disease and thyroid disease.
“In addition to its hypoglycemic effects, the GLP-1R acts on beta cells of the pancreas to stimulate insulin secretion, inhibit beta cell death, and preserve pancreatic function,” Professor Lim said. “As the drug also lowers blood pressure, while improving vascular endothelial function and cardiac contractility, it will ultimately become the main medication against diabetes.”
The results of the study were published in the Trends in Endocrinology & Metabolism, one of the most renowned endocrinology publications.