Études cardiovasculaires chez le patient diabétique de type 2 à risque : conclusions et impact des essais publiés en 2017-2018

SCHEEN, André

doi:10.1016/S1957-2557(19)30061-6

Article (Scientific journals)

Études cardiovasculaires chez le patient diabétique de type 2 à risque : conclusions et impact des essais publiés en 2017-2018

SCHEEN, André

2019 • In Médecine des Maladies Métaboliques, 13 (supplément 1), p. 10-s24

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https://hdl.handle.net/2268/235434

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10.1016/S1957-2557(19)30061-6

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Keywords :

Antidiabétiques; diabète de type 2; complications cardiovasculaires; essai clinique; prévention cardiovasculaire secondaire; mortalité.

Abstract :

[fr] Les études à visée cardiovasculaire (CV) dans le diabète de type 2 (DT2) ont concerné les trois classes antidiabétiques les plus récentes, les inhibiteurs de la dipeptidyl peptidase-4 (DPP-4) (gliptines), les agonistes des récepteurs du glucagon-like peptide-1 (GLP-1), et les inhibiteurs des cotransporteurs sodium-glucose de type 2 (SGLT2) (gliflozines). Les gliptines ont démontré leur sécurité cardiovasculaire, mais sans supériorité par rapport à un placebo. Les agonistes des récepteurs du GLP-1 ont montré une protection CV chez des patients à haut risque CV, mais avec certains résultats discordants selon les molécules testées. Les gliflozines ont montré une réduction des événements CV majeurs, tout en réduisant les hospitalisations pour insuffisance cardiaque et les événements rénaux. Les résultats des essais initiaux ont été généralement confirmés dans des études récentes, respectivement CARMELINA pour les gliptines, EXSCEL et HARMONY OUTCOMES pour les agonistes des récepteurs du GLP-1, et CANVAS et DECLARE-TIMI 58 pour les inhibiteurs des SGLT2. Les résultats de ces essais cliniques contrôlés ont considérablement impacté la nouvelle stratégie de prise en charge de l’hyperglycémie chez les patients DT2 dans le consensus ADA-EASD 2018. D’autres essais sont en cours, en particulier avec les inhibiteurs des SGLT2 chez des patients avec insuffisance cardiaque ou atteinte rénale.

Disciplines :

Cardiovascular & respiratory systems
Endocrinology, metabolism & nutrition

Author, co-author :

SCHEEN, André ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de diabétologie, nutrition, maladies métaboliques

Language :

English

Title :

Études cardiovasculaires chez le patient diabétique de type 2 à risque : conclusions et impact des essais publiés en 2017-2018

Alternative titles :

[en] Cardiovascular outcome trials in patients at high risk with type 2 diabetes: Conclusions and impact of studies published in 2017-2018

Publication date :

2019

Journal title :

Médecine des Maladies Métaboliques

ISSN :

1957-2557

eISSN :

2214-8477

Publisher :

Elsevier Masson, Paris, France

Volume :

Issue :

supplément 1

Pages :

s10-s24

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 13 May 2019

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