Glucagon-like Peptide-1 Medicines for Peripheral Arterial Disease in Type 2 Diabetes: Are They Ready for Prime Time?
Abstract
Comorbid peripheral arterial disease (PAD) affects approximately 12.5%–22% of individuals with type 2 diabetes (T2D), and is associated with an increased risk of major adverse limb events (MALE), such as revascularization procedures and lower extremity amputations, as well as heightened cardiovascular events and mortality. Despite this elevated risk, few therapies have been proven to reduce the risk of MALE. Although statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and low dose rivaroxaban plus aspirin have been shown to reduce the risk of MALE in individuals with PAD, there remains an unmet need for disease‑modifying agents to improve PAD outcomes in people with concomitant T2D and PAD.
Current Diabetes Canada guidelines recommend glucagon-like peptide-1 (GLP-1) medicines for individuals with T2D and established cardiovascular disease (CVD), multiple risk factors, or chronic kidney disease (CKD) due to their proven cardiorenal benefits. Emerging data has shown that GLP-1 medicines reduce the incidence of MALE in individuals with T2D. This review summarizes the totality of evidence for GLP-1 medicines and their impact on MALE, drawing from randomized controlled trials (RCTs) and observational studies.
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