Efficacy of dulaglutide: an evidence-based review of its potential indications

Abstract

Diabetes mellitus (DM) is the biggest noncontagious epidemic in human history. This review is addressing an urgent challenge of modern healthcare - the treatment of type 2 diabetes mellitus (DM2). Key attention is paid to the prevention of the development and progression of type 2 diabetes complications and the need to manage risk factors for cardiovascular diseases (CVD), which are the leading cause of high mortality rates in people with type 2 diabetes. The clinical trials (CT) of recent decades contributed to the build-up of a solid evidence base on the effect of various antihyperglycemic drugs on the development of diabetic complications and outcomes in patients with T2DM. Also, the emergence of innovative classes of antihyperglycemic drugs have significantly expanded the potential of T2DM therapy. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of glucose-lowering drugs that affect many pathogenetic mechanisms of T2DM and have a high safety profile. Creation of extended-release forms of GLP-1 RAs is an important step in the treatment of T2DM. Dulaglutide (Trulicity) has become the first GLP-1 RA for the treatment of T2DM (2016) authorized in Russia that can be used once weekly without regard to timing of food ingestion, which contributes to high compliance with treatment. The evidence base on the efficacy and safety of dulaglutide is continuously expanding. The authors paid attention to the issues of cardiovascular safety of the administration of dulaglutide, discussed the main results of REWIND study, and brought up a problem about the expediency of an earlier initiation of primary prevention of cardiovascular events in patients with type 2 diabetes. The results of the REWIND study made it possible to recommend the inclusion of GLP-1 RAs into the therapy of patients with type 2 diabetes and cardiovascular risk factors with a view to get additional advantages in terms of life prognosis.