JK posted a link to a great presentation entitled "A New Frontier in CV Risk Reduction for Patients With Type 2 Diabetes" that was presented at last November's American Heart Association meeting. It is presented by Darren K. McGuire, MD, MHSc; John B. Buse, MD, PhD; Benjamin M. Scirica, MD, MPH. You need a Medscape account to view, but it is free to sign up. For those of you unfamiliar with the SGLT2 and GLP1-R agonist classes of drugs, I highly recommend. 

It focuses on the SGLT2 inhibitors and GLP1-receptor agonist classes of drugs, which have been shown in recent cardiovascular outcomes trials (CVOTs) over the past few years to reduce 3-point MACE incidence in type 2 diabetics (T2D). These trials included patients both with and without prior history of cardiovascular disease (CVD). The original primary outcome read outs for % relative risk reduction (RRR) in 3-point MACE for these SGLT2 inhibitor and GLP1-R agonist trials included the combined population both w/ and w/o prior CVD. Further analysis of these trials indicated that the greatest benefit occurs in T2D patients with a past history of CVD. In the Medscape/AHA presentation there was a big emphasis on how these drugs should be prescribed to any type 2 diabetic with prior history cardiovascular disease as secondary prevention. They comprehensively covered the RRR/hazard ratio for 3-point MACE and the individual MACE events for these various trials. SGLT2 inhibitors and GLP1-R agonists are the classes of drugs for apabetalone to beat since high CVD risk type 2 diabetics are the BETonMACE patient population.

It is important to clarify that prior history of CVD (i.e. some kind of CVD in past few years) is not the same as recent acute coronary syndrome (ACS) event (i.e. ACS event within past 90-180 days). Out of all of the recent T2D CVOT trials, only EXAMINE (DPP4 inhibitor alogliptin, ACS event w/i 90 days) and ELIXA (GLP1-R agonist lixisenatide, ACS event w/i 180 days) required recent ACS event and both trials failed to meet the primary endpoint. BETonMACE requires ACS event within 7-90 days of enrollment. If BETonMACE succeeds, it will do what no DPP4 inhibitor, SGLT2 inhibitor or GLP1-R agonist has been able to do........ reduce time to subsequent 3-point MACE in patients experiencing a recent ACS event. That would be huge.

Go apabetalone! Go BETonMACE!

BearDownAZ