Cardiovascular Atlas
About
Menu

GLP-1 receptor agonists (drug class)

A group of diabetes medicines called GLP-1 receptor agonists. Some are given as a weekly injection. Large trials in people with type 2 diabetes asked whether they lower the chance of heart attack, stroke and heart-related death, and one trial asked the same question in people who had heart disease and obesity but no diabetes.

Also called GLP-1 receptor agonists · GLP-1 RAs · Glucagon-like peptide-1 receptor agonists

  • Drug
  • In this atlas

Overview

Technical summary

Class record joining the cardiovascular outcome trials of GLP-1 receptor agonists. A 2018 meta-analysis of ELIXA, LEADER, SUSTAIN 6 and EXSCEL found a 10 percent lower risk of three-point major adverse cardiovascular events (hazard ratio 0.90, 95% CI 0.82 to 0.99). Semaglutide and tirzepatide are members by the FDA established pharmacologic class listed in RxClass. SELECT tested semaglutide in people without diabetes; SURPASS-CVOT compared tirzepatide with dulaglutide.

About this drug

Level
Class
Mechanism
Not reported

Claims and evidence

Context Adults with type 2 diabetes in four GLP-1 receptor agonist cardiovascular outcome trials (ELIXA, LEADER, SUSTAIN 6, EXSCEL)

Recipient
Adult
Population
Adults aged 18 years or older with type 2 diabetes, in randomized trials that compared a GLP-1 receptor agonist with placebo and had a primary outcome that included cardiovascular death, nonfatal myocardial infarction and nonfatal stroke.
Care setting
Not stated in the abstract
Geography
Not stated in the abstract
Life stage
Adults aged 18 years or older
Follow-up
Not stated for the pooled analysis. The literature search ran up to 18 September 2017.
Eligibility: 3 inclusion criteria; exclusion criteria not stated
Included
  • Adult patients (18 years or older) with type 2 diabetes
  • Randomized comparison of a GLP-1 receptor agonist with placebo
  • Primary outcome including, but not limited to, cardiovascular mortality, nonfatal myocardial infarction and nonfatal stroke
Excluded
None stated

  • Effect Evidence synthesis Certainty not assessed

    A 2018 meta-analysis pooled four cardiovascular outcome trials of GLP-1 receptor agonists in adults with type 2 diabetes: ELIXA (lixisenatide), LEADER (liraglutide), SUSTAIN 6 (semaglutide) and EXSCEL (extended-release exenatide). Compared with placebo, the drugs lowered the risk of the three-point major adverse cardiovascular event outcome (cardiovascular death, nonfatal heart attack or nonfatal stroke) by 10 percent (hazard ratio 0.90, 95% CI 0.82 to 0.99; p=0.033). Cardiovascular death was 13 percent lower (0.87, 0.79 to 0.96) and death from any cause 12 percent lower (0.88, 0.81 to 0.95). The authors found no significant effect on fatal and non-fatal heart attack, fatal and non-fatal stroke, hospital admission for unstable angina, or hospital admission for heart failure. They also found no significant differences in severe hypoglycaemia, pancreatitis, pancreatic cancer or medullary thyroid cancer.

    Applies to Adult
    • Adults aged 18 years or older with type 2 diabetes, in randomized trials that compared a GLP-1 receptor agonist with placebo and had a primary outcome that included cardiovascular death, nonfatal myocardial infarction and nonfatal stroke.
    • Not stated in the abstract
    • Not stated in the abstract
    • Adults aged 18 years or older
    Follow-up Not stated for the pooled analysis. The literature search ran up to 18 September 2017.
    Certainty method
    Not assessed
    Limitations
    A pooled analysis of published trials of four different drugs, not of one drug. The abstract says the benefit varied to varying degrees between individual drugs and that between-trial heterogeneity was low to moderate. The search ran only up to 18 September 2017, so later trials, such as SELECT and SURPASS-CVOT in this atlas, are not in it. The abstract names the funding as Amylin Pharmaceuticals (AstraZeneca). The abstract does not grade certainty. Only the PubMed abstract was read.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (7)

    1. Supports Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, FINDINGS, sentence 1
      How it applies
      The four trials the meta-analysis found.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, FINDINGS, sentence 2
      How it applies
      Pooled hazard ratios for the three-point MACE outcome, cardiovascular death and all-cause death.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, FINDINGS, sentence 3
      How it applies
      Outcomes with no significant effect.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Supports Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, FINDINGS, sentence 4
      How it applies
      Safety outcomes with no significant difference.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Supports Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, INTERPRETATION, sentence 1; Abstract, INTERPRETATION, sentence 2
      How it applies
      The authors interpretation, including variation between individual drugs.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    6. Background Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, METHODS, sentence 1; Abstract, METHODS, sentence 2; Abstract, METHODS, sentence 3
      How it applies
      Eligible trials and the search date.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    7. Background Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis

      Publication · The lancet. Diabetes & endocrinology · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2017-12-06 · DOI: 10.1016/S2213-8587(17)30412-6 · PMID: 29221659

      Locator
      Abstract, FUNDING, sentence 1
      How it applies
      Funding line in the abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dcf556409b960c64a25ada11dce3bb914295a33577ab5cd400516c6b2657fc85
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Record details

Record id
cardio:glp1-receptor-agonists
Content hash
8f9687af6357b0d55d8e49e44dfc128ef699de180e570dcc8dfa01ccc5a04a82