In patients with advanced heart failure (HF), the drug liraglutide – an glucagon-like peptide 1 (GLP-1) agonists – does not lead to greater post-hospitalization clinical stability, according to the results of a study published Aug. 2 in the Journal of the American Medical Association.

In the Functional Impact of GLP-1 for HF Treatment (FIGHT) study, Kenneth B. Margulies, MD, et al., looked at 300 patients with established HF and reduced left ventricular ejection fraction (LVEF) who were randomized to receive either liraglutide (n = 154) or a placebo (n = 146). All patients were ranked across three hierarchical tiers: time to death, time to rehospitalization for HF, and time-averaged proportional change in N-terminal pro-B type natriuretic peptide level from baseline to 180 days.

Results showed that of the 271 patients who completed the study, liraglutide had no substantial effect on clinical stability following hospitalization. There also was no significant effect on any of the study’s secondary end points, including changes in cardiac structure and function from baseline to 180 days, six-minute walk test distances, the KCCQ clinical summary score, emergency department visits, and the composites of death and rehospitalization for HF.

Further, compared to placebo, liraglutide resulted in reduction in hemoglobin A and weight loss in patients with advanced HF and type 2 diabetes mellitus. However, several safety concerns for these patients were noted, which “suggest the need for caution and close monitoring among clinicians considering initiation of liraglutide and other GLP-1 agonists for weight loss or diabetes management in patients with HF and reduced LVEF.”

The authors conclude that their findings “do not support the use of liraglutide in this clinical situation.” 

Keywords: Diabetes Mellitus, Type 2, Emergency Service, Hospital, Glucagon-Like Peptide 1, Hospitalization, Natriuretic Peptide, Brain, Peptide Fragments, Stroke Volume, Treatment Failure, Ventricular Function, Left, Weight Loss, Heart Failure

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