Open AccessLiraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial
Author(s) -
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.
Publication year - 2018
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12334
Subject(s) - liraglutide , ejection fraction , medicine , placebo , heart failure , weight loss , cardiology , confidence interval , diabetes mellitus , type 2 diabetes , endocrinology , obesity , alternative medicine , pathology
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.