The results of the AMPLITUDE-O trial presented at ADA 2021 showed that in patients with type 2 diabetes with cardiovascular risk factors or abnormal kidney function, weekly administration of the exendin-based GLP-1* receptor agonist efpeglenatide may reduce the risk of major adverse cardiovascular events (MACE) or kidney outcomes. 

The trial included 4076 adults with T2DM and a history of CV disease or current kidney disease plus ≥1 CV risk factor. The participants were randomized to receive subcutaneous efpeglenatide (4 or 6 mg) or a weekly placebo. Over a median of 1.81 years, a considerable reduction in the incidence of MACE (nonfatal myocardial infarction, nonfatal stroke, or death from CV or undetermined causes) was observed with efpeglenatide vs. placebo. In addition, the effect of efpeglenatide was seen to be consistent irrespective of sex, age, race, diabetes duration, HbA1c, BMI, eGFR, CVD history, or SGLT2 inhibitor or metformin use. 

Participants on efpeglenatide also experienced a lower incidence of MACE composite, coronary revascularization, or hospitalization for unstable angina compared with placebo and MACE or non-CV death. It also reduced several other CV and renal risk factors vs. placebo, including HbA1c, BMI, body weight, systolic and diastolic blood pressure, pulse pressure, LDL-cholesterol, and UACR, and increased heart rate and eGFR. 

The results of the AMPLITUDE-O trial have shown that efpeglenatide is an effective cardioprotective drug for T2DM individuals with CV and/or kidney disease. 

Reference:

1. ADA 2021, session 3-CT-SY28
2. N Engl J Med 2021;doi:10.1056/NEJMoa2108269
3. Internet source. Anthony RC. Efpeglenatide reduces MACE, kidney events in high risk patients with T2D. CIMS Endocrinology. July 23, 2021. Accessed on September 17, 2021