Harold Bays, MD: Exploring Benefits and Outcomes of GLP-1 RA Treatment

In an interview with HCPLive, Harold Bays, MD, Medical Director and President of the Louisville Metabolic and Atherosclerosis Research Center, discussed the considerations of GLP-1 RA as either a staple of care or agent use that is still being defined in the cardiovascular space.

Bays led a discussion on GLP-1 receptor agonists at the 2021 American Society for Preventive Cardiology Virtual Summit on CVD Prevention.

"I think they clearly recognize that any hierarchy abuse, you're going to first implement appropriate nutrition, physical activity, then I think most people would implement Metformin therapy," Bays said. "There's a lot of reasons for that being that first line choice, but then after that, I think the the two anti-diabetes drugs that are most recommended would be the SGLT2 inhibitors and the GLP-1 RA and both of them have a little bit differences in their pharmacodynamics."

He noted this choice between the 2 agents ultimately comes down to treating the comorbid conditions of the patients, including obesity or heart failure, but no agents are available to treat both.

"For clarity, you would be using it to treat the diabetes mellitus, but the fact that there could be clinically meaningful weight loss amongst your patients with T2D, I think that that that could train you towards the decision of going in the direction of GLP-1 RA," Bays said.

Lastly, he spoke on the recent FDA decision of semaglutide in the treatment of chronic weight management, noting its development has been a remarkable step forward in diabetes treatment.

"Now, hopefully, we're gonna see similar types of technology where we could maybe convert other peptides, from injectable only into oral agents," Bays said. "From a conceptual standpoint, the development with the oral semaglutide is just remarkable. But, for semaglutide itself, the type of weight loss that we're seeing is also quite remarkable."