{"id":"2f7d240c530d","type":"article","url":"https://hartvaat.nl/2019/07/13/dulaglutide-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-lancet-rewind/","title":"Dulaglutide en cardiovasculaire uitkomsten bij diabetes type 2: Lancet REWIND","title_en":"Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","category":"preventie","category_label":"Preventie","professions":["apotheker","cardioloog","huisarts","internist"],"tags":["diabetes-en-hart","diabetes-type-1","diabetes-type-2","figaro-dkd","obesitas","roken","secundaire-preventie","select-trial","soul-trial"],"journal":"Lancet (London, England)","doi":"10.1016/S0140-6736(19)31149-3","source_url":"https://doi.org/10.1016/S0140-6736(19)31149-3","authors":["Hertzel C Gerstein","Helen M Colhoun","Gilles R Dagenais","Rafael Diaz","Mark Lakshmanan","Prem Pais","Jeffrey Probstfield","Jeffrey S Riesmeyer","Matthew C Riddle","Lars Rydén","Denis Xavier","Charles Messan Atisso","Leanne Dyal","Stephanie Hall","Purnima Rao-Melacini","Gloria Wong","Alvaro Avezum","Jan Basile","Namsik Chung","Ignacio Conget","William C Cushman","Edward Franek","Nicolae Hancu","Markolf Hanefeld","Shaun Holt","Petr Jansky","Matyas Keltai","Fernando Lanas","Lawrence A Leiter","Patricio Lopez-Jaramillo","Ernesto German Cardona Munoz","Valdis Pirags","Nana Pogosova","Peter J Raubenheimer","Jonathan E Shaw","Wayne H-H Sheu","Theodora Temelkova-Kurktschiev"],"significance":10,"published":"2019-07-13","source_date":"2019-07-13","image":"","kennis":["https://hartvaat.nl/kennis/preventie/preventie-bij-diabetes/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"The REWIND trial showed that once-weekly dulaglutide reduced the composite of cardiovascular death, nonfatal MI, and nonfatal stroke in patients with type 2 diabetes, including a substantial proportion at primary prevention level. This broadened the evidence for GLP-1 receptor agonists to a lower-risk, more representative diabetes population.","created":"2026-07-03T10:28:02Z","updated":"2026-07-03T13:27:14Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Lancet REWIND-trial die aantoonde dat dulaglutide cardiovasculaire events vermindert bij diabetes type 2, inclusief primaire preventie. Breedste GLP-1-populatie tot nu toe.","abstract_original":"BACKGROUND: Three different glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular outcomes in people with type 2 diabetes at high cardiovascular risk with high glycated haemoglobin A1c (HbA1c) concentrations. We assessed the effect of the GLP-1 receptor agonist dulaglutide on major adverse cardiovascular events when added to the existing antihyperglycaemic regimens of individuals with type 2 diabetes with and without previous cardiovascular disease and a wide range of glycaemic control. METHODS: This multicentre, randomised, double-blind, placebo-controlled trial was done at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo. Randomisation was done by a computer-generated random code with stratification by site. All investigators and participants were masked to treatment assignment. Participants were followed up at least every 6 months for incident cardiovascular and other serious clinical outcomes. The primary outcome was the first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes (including unknown causes), which was assessed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT01394952. FINDINGS: Between Aug 18, 2011, and Aug 14, 2013, 9901 participants (mean age 66·2 years [SD 6·5], median HbA1c 7·2% [IQR 6·6-8·1], 4589 [46·3%] women) were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). During a median follow-up of 5·4 years (IQR 5·1-5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants at an incidence rate of 2·7 per 100 person-years in the placebo group (hazard ratio [HR] 0·88, 95% CI 0·79-0·99; p=0·026). All-cause mortality did not differ between groups (536 [10·8%] in the dulaglutide group vs 592 [12·0%] in the placebo group; HR 0·90, 95% CI 0·80-1·01; p=0·067). 2347 (47·4%) participants assigned to dulaglutide reported a gastrointestinal adverse event during follow-up compared with 1687 (34·1%) participants assigned to placebo (p<0·0001). INTERPRETATION: Dulaglutide could be considered for the management of glycaemic control in middle-aged and older people with type 2 diabetes with either previous cardiovascular disease or cardiovascular risk factors. FUNDING: Eli Lilly and Company."}