Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimising Cardiovascular Outcomes in Patients with Type 2 Diabetes

Tan, Jack Wei Chieh; Sim, David; Ako, Junya; Almahmeed, Wael; Cooper, Mark E.; Dalal, Jamshed; Deerochanawong, Chaicharn; Huang, David Wei Chun; Johar, Sofian; Kaul, Upendra; Kim, Sin Gon; Koh, Natalie; Kong, Alice Pik Shan; Krittayaphong, Rungroj; Kwok, Bernard W.K.; Matawaran, Bien J.; Nguyễn, Quang Ngọc; Ong, Loke Meng; Park, Jin Joo; Peng, Yongde; Quek, David Kl; Suastika, Ketut; Sukor, Norlela; Teo, Boon Wee; Teoh, Chee Kiang; Zhang, Jiän; Reyes, Eugenio B.; Goh, Su-Yen

doi:10.15420/ecr.2020.52

Cited by 7 publications

(6 citation statements)

References 53 publications

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“… / 2020 American College of Cardiology “Expert consensus decision pathway for novel therapies to reduce cardiovascular risk in patients with type 2 diabetes mellitus” 13 American College of Cardiology GLP-1RA with evidence of ASCVD benefit Patients with T2DM with one or more ASCVD or high risk of ASCVD may choose GLP-1RA therapy with cardiovascular benefits. / Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimizing Cardiovascular Outcomes in Patients with Type 2 Diabetes 14 Asia-Pacific Society of Cardiology GLP-1RA with evidence of ASCVD benefit In patients with T2DM with normal renal function and high risk of cardiovascular events, GLP-1RA with proven cardiovascular benefit is recommended. / Expert consensus on the diagnosis and treatment of cardiovascular disease in patients with diabetes mellitus 15 National Health Commission Capacity Building and Continuing Education Center GLP-1RA with evidence of ASCVD benefit In patients with ASCVD, the preferred GLP-1RA with proven cardiovascular benefit should be considered for glycemic and weight control.…”

Section: Resultsmentioning

confidence: 99%

A Health Technology Assessment Based on Chinese Guidelines: Glucagon-Like Peptide-1 Receptor Agonist in the Treatment of Type 2 Diabetes Complicated with Cardiovascular Disease

Xie¹,

Li²,

Yang³

et al. 2022

TCRM

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Purpose According to the requirements of the “Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions”, this health technology assessment provides an evidence-based basis for drug selection and rational clinical use of glucagon-like peptide-1 receptor agonist drugs in medical institutions. Methods We consult the drug instructions, clinical treatment guidelines and search relevant documents in databases such as China national knowledge infrastructure, Wanfang, PubMed, and government websites such as National Medical Products Administration, Food and Drug Administration, European Medicines Agency, and Pharmaceuticals and Medical Devices Agency to collect and sort out the relevant information of the indications, pharmacological effects, guideline recommendations, drug prices and other information of glucagon-like peptide-1 receptor agonists, using a percentile system systematically evaluate the five dimensions of glucagon-like peptide-1 receptor agonists in terms of pharmaceutical properties, efficacy, safety, economy, and other attributes. Results The final scores of the evaluation results from high to low are semaglutide (71.00 points), dulaglutide (68.75 points), liraglutide (67.50 points), exenatide (67.00 points), lixisenatide (63.50 points), polyethylene glycol loxenatide (58.00 points) and benaglutide (49.00 points). Conclusion In clinical practice, semaglutide and dulaglutide are the top two drugs that can be used as recommended drugs. This health technology assessment can provide an evidence-based basis for hospital selection and rational use of glucagon-like peptide-1 receptor agonists. Clinicians can rationally choose and use drugs according to the patient’s conditions and needs.

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Section: Resultsmentioning

confidence: 99%

A Health Technology Assessment Based on Chinese Guidelines: Glucagon-Like Peptide-1 Receptor Agonist in the Treatment of Type 2 Diabetes Complicated with Cardiovascular Disease

Xie¹,

Li²,

Yang³

et al. 2022

TCRM

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“…While most countries in the Asia-Pacific region have national guidelines, there is no regional Asia-Pacific hypertension guideline, even though there are consensus documents for other noncommunicable diseases, such as diabetes and dyslipidaemia [ 162 , 163 ]. There is also some variability between the guidelines in Asia-Pacific, with not all local guidelines conforming to international guidelines, such as those from ISH (Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Management of Hypertension in the Asia-Pacific Region: A Structured Review

Rahman,

Magno,

Cai

et al. 2024

Am J Cardiovasc Drugs

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This article reviews available evidence regarding hypertension management in the Asia-Pacific region, focussing on five research questions that deal with specific aspects: blood pressure (BP) control, guideline recommendations, role of renin–angiotensin–aldosterone system (RAAS) inhibitors in clinical practice, pharmacological management and real-world adherence to guideline recommendations. A PubMed search identified 2537 articles, of which 94 were considered relevant. Compared with Europeans, Asians have higher systolic/diastolic/mean arterial BP, with a stronger association between BP and stroke. Calcium channel blockers are the most-commonly prescribed monotherapy in Asia, with significant variability between countries in the rates of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin-receptor blockers (ARBs) and single-pill combination (SPC) use. In clinical practice, ARBs are used more commonly than ACEis, despite the absence of recommendation from guidelines and clinical evidence supporting the use of one class of drug over the other. Ideally, antihypertensive treatment should be tailored to the individual patient, but currently there are limited data on the characteristics of hypertension in Asia-Pacific individuals. Large outcome studies assessing RAAS inhibitor efficacy and safety in multi-national Asian populations are lacking. Among treated patients, BP control rates were ~ 35 to 40%; BP control in Asia-Pacific is suboptimal, and disproportionately so compared with Western nations. Strategies to improve the management of hypertension include wider access/availability of affordable treatments, particularly SPCs (which improve adherence), effective public health screening programs targeting patients to drive health-seeking behaviours, an increase in physician/patient awareness and early implementation of lifestyle changes. A unified Asia-Pacific guideline on hypertension management with pragmatic recommendations, particularly in resource-limited settings, is essential. Supplementary Information The online version contains supplementary material available at 10.1007/s40256-023-00625-1.

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“…Various professional societies and organisations have included early initiation of SGLT2i from various perspectives including diabetes, congestive heart failure, and diabetic and nondiabetic kidney disease. [11][12][13] In patients with risk of CKD and ESKD, early initiation of SGLT2i may prevent the complications of CKD.…”

Section: Sglt2i: Kidney Function and Recommendationsmentioning

confidence: 99%

Acting on the Latest SGLT2i Evidence to Treat CKD Patients in Primary Care

2021

SFP

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The prevalence of Chronic Kidney Disease (CKD) in Singapore is increasing due to an ageing Singapore population and the increasing prevalence of risk factors such as hypertension and diabetes. Screening using serum creatinine and urine albumin to creatinine ratio (UACR) aids in the detection and classification of CKD. This allows interventions for the retardation of kidney function decline and the prevention of the complications of CKD, which includes endstage kidney disease (ESKD), anaemia, mineral bone disorder, and mortality. Besides the optimal use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARB) in both diabetic and non-diabetic CKD, sodiumglucose cotransporter type 2 inhibitors (SGLT2i) have been identified to retard CKD, prevent ESKD, and mortality. More recent studies suggest that regardless of the degree of albuminuria or glycated haemoglobin, SGLT2i improves the outcomes of CKD patients. Moreover, SGLT2i can be initiated with an estimated glomerular filtration rate as low as 20 mL per minute per 1.73 m 2 body surface area. As nephron loss is irreversible, aggressive control of risk factors to target goals and using kidney-protective medications such as ACE-I, ARB, and SGLT2i are crucial in the remission of early CKD.

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Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimising Cardiovascular Outcomes in Patients with Type 2 Diabetes

Cited by 7 publications

References 53 publications

A Health Technology Assessment Based on Chinese Guidelines: Glucagon-Like Peptide-1 Receptor Agonist in the Treatment of Type 2 Diabetes Complicated with Cardiovascular Disease

A Health Technology Assessment Based on Chinese Guidelines: Glucagon-Like Peptide-1 Receptor Agonist in the Treatment of Type 2 Diabetes Complicated with Cardiovascular Disease

Management of Hypertension in the Asia-Pacific Region: A Structured Review

Acting on the Latest SGLT2i Evidence to Treat CKD Patients in Primary Care

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