Trulicity ® (dulaglutide)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information. Please refer to the link for full prescribing information: Trulicity Summary of Product Characteristics (SmPC)

Trulicity® (dulaglutide): REWIND Baseline Characteristics Video

In the REWIND study a total of 9901 patients in 24 countries were randomized. The average age was 66.2 years and the average HbA1c was 7.3 %. Around 1/3 had prior CVD, so most of the participants did not have previous CV disease or a previous CV event.

Detailed Information

The REWIND study was an event-driven, randomized, double-blind, phase 3 CV outcomes study of dulaglutide.1

The study evaluated the effect on MACE-3 and other serious outcomes with once-weekly dulaglutide 1.5 mg treatment compared with placebo when added to standard of care in participants 50 years of age and older with T2DM and established CV disease and/or risk factors.1

Eligible patients had

  • newly diagnosed or established T2DM

  • an HbA1c value of 9.5% or lower, and

  • vascular diseases or CV risk factors depending on their age (Table 1).1,2

Table 1. Age-Specific Inclusion Criteria for REWIND Trial1

If the participant's age was... 

Then they had to have... 

50-54 y

established CVD. 

55-59 y

established CVD or evidence of other subclinical CVD. 

60 y or older

established CVD, evidence of other subclinical CVD, or at least 2 other CV risk factors.

Abbreviations: CV = cardiovascular; CVD = cardiovascular disease; REWIND = Researching cardiovascular Events with a Weekly INcretin in Diabetes.

Patients were excluded if they had

  • liver disease

  • a history of pancreatitis

  • gastric emptying abnormalities

  • an eGFR of less than 15 mL/min/1.73m2 or on dialysis

  • a coronary or cerebrovascular event in the last 2 months or plans to revascularize, or

  • history of medullary C-cell hyperplasia or medullary thyroid cancer.1,2

A total of 9901 patients in 24 countries were randomized.2

More detailed information on baseline characteristics is found in

Table 2. Baseline Characteristics of Patients Randomized in the REWIND Study2

Clinical Characteristics

Dulaglutide
n=4949

Placebo
n=4952

Age, y, mean (SD)

66.2 (6.5)

66.2 (6.5)

Females, n (%)

2306 (46.6)

2283 (46.1)

DM duration, y,  mean (SD)

10.5 (7.3)

10.6 (7.2)

HbA1c, %, mean (SD)

7.3 (1.1)

7.4 (1.1)

BMI, kg/m2, mean (SD)

32.3 (5.7)

32.3 (5.8)

BP, mmHg, mean (SD)

137.1 (16.6)/78.4 (9.8)

137.3 (17.0)/78.5 (9.9)

Pulse, beats/min, mean (SD)

71.4 (10.7)

71.6 (11.0)

Cholesterol, mmol/L [mg/dL],  Mean (SD)

4.52 (1.16) [174.79 (44.86)]

4.52 (1.16) [174.79 (44.86)]

LDL cholesterol, mmol/L [mg/dL],  Mean (SD)

2.56 (0.98) [98.99 (37.90)]

2.56 (0.98) [98.99 (37.90)]

HDL cholesterol, mmol/L [mg/dL],  Mean (SD)

1.18 (0.33) [45.63 (12.76)]

1.18 (0.36) [45.63 (13.92)]

Median triglycerides (IQR), mmol/L [mg/dL], Mean (SD)

1.60 (1.15-2.2) [141.72 (101.86-194.86)]

1.60 (1.20-2.25) [141.72 (106.29-199.30)]

eGFR<60 mL/min/1.73 m2, n (%)

1081 (21.8)

1118 (22.6)

Albuminuria, n (%)a

1707 (34.5)

1760 (35.5)

Prior CV disease b, n (%)

1560 (31.5)

1554 (31.4)

Prior hypertension, n (%)

4605 (93.0)

4619 (93.3)

Prior heart failure, n (%)

421 (8.5)

432 (8.7)

Prior diabetic retinopathy, n (%)

448 (9.1)

443 (8.9)

Current tobacco use, n (%)

694 (14.0)

713 (14.4)

Abbreviations: BMI = body mass index; BP = blood pressure; CV = cardiovascular; DM = diabetes mellitus; eGFR = estimated glomerular filtration rate; HbA1c = glycated hemoglobin; HDL = high-density lipoprotein; IQR = interquartile range; LDL = low-density lipoprotein; REWIND = Researching cardiovascular Events with a Weekly INcretin in Diabetes.

a UACR ≥30 mg/g

b Myocardial infarction, ischemic stroke,unstable angina with electrocardiogram changes, myocardial ischemia on imaging or stress test, or coronary, carotid,or peripheral revascularization.

References

1. Gerstein HC, Colhoun HM, Dagenais GR, et al. REWIND Trial Investigators. Design and baseline characteristics of participants in the Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND) trial on the cardiovascular effects of dulaglutide. Diabetes Obes Metab. 2018;20(1):42-49. https://doi.org/10.1111/dom.13028

2. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. The Lancet. 2019;394(10193):121-130. https://doi.org/10.1016/S0140-6736(19)31149-3

Glossary

CV = cardiovascular

CVD = cardiovascular disease

eGFR = estimated glomerular filtration rate

HbA1c = glycated hemoglobin

MACE-3 = major adverse cardiovascular events (death due to cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke)

REWIND = Researching cardiovascular Events with a Weekly INcretin in Diabetes

T2DM = type 2 diabetes mellitus

Date of Last Review: March 02, 2020


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