Effects of Once-Weekly Exenatide on Clinical Outcomes in Patients With Preexisting Cardiovascular Disease: Prespecified Analysis From EXSCEL

The Exenatide Study of Cardiovascular Event Lowering (EXSCEL) was an international trial in a broad population of patients with type 2 diabetes (T2DM) including by design those with (~70%) and without (~30%) known cardiovascular (CV) disease.1-3 Once-weekly exenatide (EQW) resulted in a nominal 9% relative reduction in major adverse CV events (MACE; P-value for superiority = .061) and a 14% relative reduction in all-cause mortality (nominal P-value for superiority = .016) compared with placebo. These effects on MACE were consistent in those with and without known CV disease at baseline (interaction P-value = .50). We performed a prespecified subgroup analysis of EQW on outcomes in EXSCEL in patients with known CV disease at baseline. EXSCEL enrolled 14,752 patients between June 2010 and September 2015. The design, baseline characteristics, and primary results have been published.1-3 In brief, EXSCEL investigated the effects of the once-weekly GLP-1 receptor agonist (GLP-1 RA) exenatide (2-mg injection) on...