Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction

insights from the FIGHT trial

Abhinav Sharma, Andrew P. Ambrosy, Adam D. DeVore, Kenneth B. Margulies, Steven E. McNulty, Robert J. Mentz, Adrian F. Hernandez, Gary Michael Felker, Lauren B. Cooper, Anuradha Lala, Justin Vader, John D. Groake, Barry A Borlaug, Eric J. Velazquez

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Aims: Obesity is present in up to 45% of patients with heart failure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with HF and reduced ejection fraction (HFrEF) and a recent acute HF hospitalization remains unknown. Methods and results: The Functional Impact of GLP-1 for Heart Failure Treatment study randomized 300 patients with HFrEF (ejection fraction ≤ 40%), both with and without diabetes and a recent HF hospitalization to liraglutide or placebo. The primary outcome for this post hoc analysis was the change in weight from baseline to last study visit. We conducted an ‘on-treatment’ analysis of patients with at least one follow-up visit on study drug (123 on liraglutide and 124 on placebo). The median age was 61 years, 21% were female, and 69% of patients had New York Heart Association functional Class III or IV symptoms. The median ejection fraction was 25% (25th, 75th percentile 19–32%). Liraglutide use was associated with a significant weight reduction [liraglutide −1.00 lbs vs. placebo 2.00 lbs; treatment difference −4.10 lbs; 95% confidence interval (CI) −7.94, −0.25; P = 0.0367; percentage treatment difference −2.07%, 95% CI −3.86, −0.28; P = 0.0237]. Similar results were seen after multivariable adjustments. Liraglutide also significantly reduced triglyceride levels (liraglutide 7.5 mg/dL vs. placebo 12.0 mg/dL; treatment difference −33.1 mg/dL; 95% CI −60.7, −5.6; P = 0.019). Conclusions: Liraglutide is an efficacious weight loss agent in patients with HFrEF. These findings will require further exploration in a well-powered cardiovascular outcomes trial.

Original languageEnglish (US)
JournalESC heart failure
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Weight Loss
Heart Failure
Placebos
Anti-Obesity Agents
Confidence Intervals
Hospitalization
Therapeutics
Liraglutide
Glucagon-Like Peptide 1
Triglycerides
Obesity
Weights and Measures
Pharmaceutical Preparations

Keywords

  • Diabetes
  • Heart failure
  • Liraglutide
  • Weight loss

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sharma, A., Ambrosy, A. P., DeVore, A. D., Margulies, K. B., McNulty, S. E., Mentz, R. J., ... Velazquez, E. J. (Accepted/In press). Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial. ESC heart failure. https://doi.org/10.1002/ehf2.12334

Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction : insights from the FIGHT trial. / Sharma, Abhinav; Ambrosy, Andrew P.; DeVore, Adam D.; Margulies, Kenneth B.; McNulty, Steven E.; Mentz, Robert J.; Hernandez, Adrian F.; Michael Felker, Gary; Cooper, Lauren B.; Lala, Anuradha; Vader, Justin; Groake, John D.; Borlaug, Barry A; Velazquez, Eric J.

In: ESC heart failure, 01.01.2018.

Research output: Contribution to journalArticle

Sharma, A, Ambrosy, AP, DeVore, AD, Margulies, KB, McNulty, SE, Mentz, RJ, Hernandez, AF, Michael Felker, G, Cooper, LB, Lala, A, Vader, J, Groake, JD, Borlaug, BA & Velazquez, EJ 2018, 'Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial', ESC heart failure. https://doi.org/10.1002/ehf2.12334
Sharma, Abhinav ; Ambrosy, Andrew P. ; DeVore, Adam D. ; Margulies, Kenneth B. ; McNulty, Steven E. ; Mentz, Robert J. ; Hernandez, Adrian F. ; Michael Felker, Gary ; Cooper, Lauren B. ; Lala, Anuradha ; Vader, Justin ; Groake, John D. ; Borlaug, Barry A ; Velazquez, Eric J. / Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction : insights from the FIGHT trial. In: ESC heart failure. 2018.
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AU - Hernandez, Adrian F.

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AU - Cooper, Lauren B.

AU - Lala, Anuradha

AU - Vader, Justin

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N2 - Aims: Obesity is present in up to 45% of patients with heart failure (HF). Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor antagonist, facilitates weight loss in obese patients. The efficacy of liraglutide as a weight loss agent among patients with HF and reduced ejection fraction (HFrEF) and a recent acute HF hospitalization remains unknown. Methods and results: The Functional Impact of GLP-1 for Heart Failure Treatment study randomized 300 patients with HFrEF (ejection fraction ≤ 40%), both with and without diabetes and a recent HF hospitalization to liraglutide or placebo. The primary outcome for this post hoc analysis was the change in weight from baseline to last study visit. We conducted an ‘on-treatment’ analysis of patients with at least one follow-up visit on study drug (123 on liraglutide and 124 on placebo). The median age was 61 years, 21% were female, and 69% of patients had New York Heart Association functional Class III or IV symptoms. The median ejection fraction was 25% (25th, 75th percentile 19–32%). Liraglutide use was associated with a significant weight reduction [liraglutide −1.00 lbs vs. placebo 2.00 lbs; treatment difference −4.10 lbs; 95% confidence interval (CI) −7.94, −0.25; P = 0.0367; percentage treatment difference −2.07%, 95% CI −3.86, −0.28; P = 0.0237]. Similar results were seen after multivariable adjustments. Liraglutide also significantly reduced triglyceride levels (liraglutide 7.5 mg/dL vs. placebo 12.0 mg/dL; treatment difference −33.1 mg/dL; 95% CI −60.7, −5.6; P = 0.019). Conclusions: Liraglutide is an efficacious weight loss agent in patients with HFrEF. These findings will require further exploration in a well-powered cardiovascular outcomes trial.

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