Blake L. Erdel, MD, Diabetes \u0026 Endocrinology Specialists, Indianapolis
PubMed: Background Cardiovascular outcome trials have suggested that glucagon-like peptide 1 GLP-1 receptor agonists might reduce strokes.
We analysed the effect of dulaglutide on stroke within the researching cardiovascular events with a weekly incretin in diabetes REWIND trial.
Methods REWIND was a multicentre, randomised, double-blind, placebo-controlled trial done at sites in 24 countries. Participants were randomly assigned to weekly subcutaneous injections of either masked dulaglutide 1.
Randomisation was done by a computer-generated random code with an interactive web response system with stratification by site. Participants, investigators, the trial leadership, and all other personnel were masked to treatment allocation until the trial was completed and the database was locked.
During the treatment period, participants in both groups were instructed to inject study drug on the same day at around the same time, each week.
Strokes were categorised as fatal or non-fatal, and as either ischaemic, haemorrhagic, or undetermined. Stroke severity was assessed using the modified Rankin scale.
Participants were seen at 2 weeks, 3 months, 6 months, and then every 3 months for drug dispensing and every 6 months for detailed assessments, until confirmed primary outcomes accrued.
The primary endpoint was the first occurrence of any component of the composite outcome, which comprised non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular or unknown causes. All analyses were done according to an intention-to-treat strategy that included all randomly assigned participants, irrespective of adherence.
Submitted manuscripts may report any aspect of laboratory, animal, or human research related to diabetes and its cardiovascular complications". The total growth rate of Diabetologia IF is Septemberissue 9.
The trial is registered with ClinicalTrials. During a median follow-up of 5. Dulaglutide reduced ischaemic stroke 0.
Dulaglutide also reduced the composite of non-fatal stroke or all-cause death 0. The degree of disability after stroke did not differ by treatment group. Interpretation Long-term dulaglutide use might reduce clinically relevant ischaemic stroke in people with type 2 diabetes but does not affect stroke severity.
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