Liraglutide

Liraglutide is a once-daily GLP-1 receptor agonist used for Type 2 Diabetes, obesity, and cardiovascular risk reduction.

Brand names:

• Victoza (Type 2 Diabetes)
• Saxenda (Obesity)

→ GLP-1 Receptor Agonists Overview

Liraglutide activates the GLP-1 receptor.

Effects:

• Increases glucose-dependent insulin secretion
• Decreases glucagon secretion
• Slows gastric emptying
• Increases satiety
• Promotes weight loss

Net clinical effects:

• Decreases HbA1c
• Reduces body weight
• Reduces major adverse cardiovascular events

Low hypoglycemia risk unless combined with insulin or sulfonylureas.

• Glycemic control
• Cardiovascular risk reduction

• Chronic weight management
• Reduces visceral adiposity
• Improves metabolic risk factors

Liraglutide reduces:

• Myocardial infarction
• Stroke
• Cardiovascular death

→ Cardiovascular Modules

LEADER Trial:

• Reduced cardiovascular death
• Reduced major adverse cardiovascular events
• Demonstrated mortality benefit in high-risk patients

• Once-daily subcutaneous injection
• Titrate gradually to minimize GI side effects

No oral formulation.

Common:

• Nausea
• Vomiting
• Diarrhea
• Early satiety

Serious (rare):

• Pancreatitis
• Gallbladder disease
• Theoretical risk of medullary thyroid carcinoma

• Personal or family history of medullary thyroid carcinoma
• MEN2 syndrome
• Severe gastrointestinal disease

Use caution in:

• History of pancreatitis

Exenatide

• Shorter-acting options available
• Less robust ASCVD data

Dulaglutide

• Weekly injection
• Strong primary prevention data

Semaglutide

• Greater weight loss
• Oral formulation available
• Strong ASCVD data

Liraglutide:

• First GLP-1 to show mortality reduction
• Daily dosing

Liraglutide:

• Strong ASCVD reduction
• Modest weight loss
• Minimal heart failure benefit

SGLT2 Inhibitors:

• Strong heart failure benefit
• Strong renal protection

• First GLP-1 with proven CV mortality reduction
• Daily injection
• Useful in obesity and diabetes
• Not a primary heart failure therapy

• GLP-1 Receptor Agonists
• SGLT2 Inhibitors
• Cardiovascular Modules