Cardiovascular Outcomes Are the Focus of Evidence-Based Diabetes ManagementTM, a Publication of The American Journal of Managed Care&reg

CRANBURY, N.J.—Some drugs to treat type 2 diabetes are now being marketed to prevent heart attacks and strokes in high-risk patients, and new research may lead to approvals for more patients to take them, according to the current issue of Evidence-Based Diabetes Management^TM (EBDM^TM), a publication of The American Journal of Managed Care^®.

The full issue can be found here.

A decade ago, the FDA began requiring a new type of clinical trial, the cardiovascular outcomes trial, to make sure diabetes and obesity drugs were safe. In 2015, came a surprise—the sodium glucose co-transporter-2 (SGLT2) inhibitor empagliflozin (Jardiance) not only lowered blood sugar levels, but also reduced the risk of heart attacks and cardiovascular death. Since then, another SGLT2 inhibitor, canagliflozin (Invokana) was found to have benefits, along with 2 drugs in the glucagon-like peptide-1 (GLP-1) class.

The issue explores how these unexpected results have sent scientists looking for new evidence about diabetes therapies, both in clinical trials and in observational or “real world” studies. Additionally, the issue covers how the cost of some therapies have made payers wary of making them widely available. Articles include:

• An interview with Eldrin F. Lewis, MD, MPH, FACC, of Brigham & Women’s Hospital on how heart failure is finally gaining attention as an endpoint in diabetes drug trials.
• A commentary by Horizon Blue Cross Blue Shield of New Jersey Chief Medical Officer Thomas R. Graf, MD, about the new era of accountability for pharma, using the example of evolocumab (Repatha), a PCSK9 inhibitor that treats high LDL cholesterol.
• An interview with Matthew A. Cavender, MD, MPH, FACC, co-author of the CVD-REAL trial, which gained attention earlier this year when it used claims and health registry data to mirror results of cardiovascular outcomes trials for SGLT2 inhibitors.

The need to balance cost considerations with the potential to prevent major cardiovascular events in patients with diabetes points to the need for personalized care. And precision medicine is coming to diabetes management, writes EBDM^TM Editor-in-Chief Robert A. Gabbay, MD, PhD, FACP, who discusses results from Joslin Diabetes Center, where he is chief medical officer. Just as EBDM^TM headed to press, Joslin scientists published a paper that found genetic links between GLP-1 and cardiovascular mortality and may explain unexpected results from the large ACCORD trial.

Recent results, Gabbay writes, “are of interest to payers, who are interested in getting the right drugs to the right patients, and who want proof that therapies can reduce costs in high-risk populations.”

About The American Journal of Managed Care^®:

The American Journal of Managed Care^® (AJMC^®) is a peer-reviewed, MEDLINE-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. AJMC.com is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC^® family include The American Journal of Accountable Care^®, and two evidence-based series, Evidence-Based Oncology™ and Evidence-Based Diabetes Management™. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC^® publications, please contact Jeff Prescott at 609-716-7777, ext. 331.

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