Stephen Wiviott, MD: Changes in the Treatment of Type 2 Diabetes
NOVEMBER 30, 2018
Cecilia Pessoa Gingerich
Diabetes drugs like SGLT2 inhibitors—including dapagliflozin—and GLP-1 receptor agonists are changing how clinicians treat patients with diabetes and cardiovascular risks. Recent studies like the DECLARE-TIMI 58 trial of dapagliflozin showed that there are cardiovascular benefits in addition to the ability to manage diabetes.
“I think we're moving into a time where we're going to be really switching the paradigm of how we manage our patients with diabetes and cardiovascular risk,” Stephen Wiviott, MD, told MD Magazine®.
Wiviott, senior investigator of the TIMI Study Group, cardiologist at Brigham and Women’s Hospital, and Associate Professor of Medicine at Harvard Medical School, presented the study results at the American Heart Association’s Scientific Sessions 2018 in Chicago, IL. Wiviott also spoke with MD Mag about the strengths and limitations of the DECLARE trial.
Wiviott said that clinicians can expect to see more data from the DECLARE-TIMI 58 trial regarding specific subgroups, kidney disease, and biomarkers. The data may help identify which groups of patients benefit more from taking dapagliflozin.
Future research may point to other patients who could benefit—perhaps even patients without diabetes, according to Wiviott.
[Transcript has been edited for clarity.]
The other interesting thing is that because of the results of these types of trials over the past few years—with successful cardiovascular benefit with the SGLT2 inhibitors—there is a lot of ongoing research trying to even broaden out the population potentially further. So, patients who are being treated for heart failure, patients with chronic kidney disease, and even in some patients who don't have diabetes. The concept is whether these drugs may be beneficial independent of their effects on blood sugar. So, really a lot of exciting research going on with these classes of agents.
“I think we're moving into a time where we're going to be really switching the paradigm of how we manage our patients with diabetes and cardiovascular risk,” Stephen Wiviott, MD, told MD Magazine®.
Wiviott, senior investigator of the TIMI Study Group, cardiologist at Brigham and Women’s Hospital, and Associate Professor of Medicine at Harvard Medical School, presented the study results at the American Heart Association’s Scientific Sessions 2018 in Chicago, IL. Wiviott also spoke with MD Mag about the strengths and limitations of the DECLARE trial.
Wiviott said that clinicians can expect to see more data from the DECLARE-TIMI 58 trial regarding specific subgroups, kidney disease, and biomarkers. The data may help identify which groups of patients benefit more from taking dapagliflozin.
Future research may point to other patients who could benefit—perhaps even patients without diabetes, according to Wiviott.
[Transcript has been edited for clarity.]
What further data will be released from the DECLARE-TIMI 58 trial?
There’s lots of additional research being done in this area. I think it's a very exciting area presently. Certainly, we will have more information from this study, in terms of specific subgroups and other types of outcomes. There will be a lot more information about kidney disease coming forward soon. There will be information about biomarkers. We start to wonder whether we might be able to identify specific groups of patients which benefit more.The other interesting thing is that because of the results of these types of trials over the past few years—with successful cardiovascular benefit with the SGLT2 inhibitors—there is a lot of ongoing research trying to even broaden out the population potentially further. So, patients who are being treated for heart failure, patients with chronic kidney disease, and even in some patients who don't have diabetes. The concept is whether these drugs may be beneficial independent of their effects on blood sugar. So, really a lot of exciting research going on with these classes of agents.