Peripheral arterial disease is an early cardiovascular manifestation and prevailing in up to 30 % of people with type 2 diabetes, characterized by atherosclerosis of the arteries that leads to deteriorated perfusion and reduced functional capacity.
In people with type 2 diabetes, peripheral arterial disease is associated with greater functional deterioration and higher rates of adverse events in the extremities and amputation, mainly due to the highest prevalence of small vessel disease below the knee.
The treatment options are currently limited and in more than 25 years there have been few significant therapeutic advances in this condition.
The Stride essay is a phase 3 clinical study, multinational, with double masking, randomized, carried out in 112 outpatient centers from 20 countries in North America, Asia and Europe. 792 patients over 18 with type 2 diabetes and peripheral arterial disease with intermittent claudication (a symptom of the disease that causes pain or muscle cramps in the legs during physical activity) and an ankle-axplane index or reduced finger-jerk (indicators of blood flow restricted in the legs) were included. Placebo (n = 396) for a period of 52 weeks in order to evaluate the impact on the ability to walk, symptoms and quality of life. The middle ages was 68 years; 195 participants (25 %) were women and 597 (75 %) men.
The analysis showed that Semaglutida significantly improved the marching capacity in people with peripheral arterial disease and diabetes, improved the quality of life and reduced the risk of disease progression by 54 %. A week 52 The estimated ratio of the maximum walking with respect to the baseline was 1.21 in the group with semaglutida compared to 1.08 in the placebo group. Semaglutida was well tolerated, without deaths related to treatment and with low rate of serious adverse events (1 %), consisting of their safety profile already known.
Expert opinion
This Stride analysis generated new and critical information on the semaglutidal benefits (1.0 mg subcutaneous once a week) in patients with symptomatic peripheral arterial disease and type 2 diabetes with an average duration of 12.2 years and glucosylated hemoglobin of 7.1 %, which were observed independently of the basal levels of glucosylated hemoglobin, the duration of diabetes or intensity of diabetes treatment. In addition, the benefits were observed in all categories of body mass index and regardless of whether patients received inhibitors from the type 2 sodium-glucose collection of type 2. These findings indicate that the semaglutide is a drug with vascular protective effect, with benefits that go beyond weight reduction or glucosylated hemoglobin.
The Dra. Cecilia bahit She is a cardiologist, graduated from the University of Buenos Aires, and is currently head of the Department of Cardiology of Ineco Neurosciences Oroño, in Rosario, Argentina.
