1
|
Kyriakidou A, Kyriazou AV, Koufakis T, Vasilopoulos Y, Avramidis I, Baltagiannis S, Goulis DG, Kotsa K. Association between variants in TCF7L2, CTRB1/2, and GLP-1R genes and response to therapy with glucagon-like peptide-1 receptor agonists. Postgrad Med 2024; 136:218-225. [PMID: 38453649 DOI: 10.1080/00325481.2024.2328513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/06/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The factors determining the response to treatment with glucagon-like peptide-1 receptor agonists (GLP-1- RAs) have not been clarified. The present study investigated the association between polymorphisms in TCF7L2, CTRB1/2, and GLP-1 R genes and response to GLP-1 RAs regarding glycemic control and weight loss among Greek patients with type 2 diabetes mellitus (T2DM). METHODS Patients (n = 191) treated with GLP-1 RAs for at least 6 months were included. Participants were genotyped for TCF7L2 rs7903146 (C>T), CTRB1/2 rs7202877 (T>G) and GLP-1 R rs367543060 (C>T) polymorphisms. Clinical and laboratory parameters were measured before, 3, and 6 months after treatment initiation. The patients were classified into responders and non-responders according to specific criteria. RESULTS Carriers of at least one rs7903146 'T' allele and rs7202877 'G' allele presented similar glucose control and weight loss response to GLP-1 RAs with the respective homozygous wild-type genotypes [odds ratio (OR): 1.08, 95% confidence interval (CI): 0.5, 2.31, p = 0.85 and OR: 1.35, 95% CI: 0.66, 2.76, p = 0.42; OR: 1.4, 95% CI: 0.56, 3.47, p = 0.47 and OR: 1.28, 95% CI: 0.55, 2.98, p = 0.57, respectively]. Regarding the GLP-1 R polymorphism, all participants were homozygous for the wild-type allele; thus, no comparisons were feasible. Female sex (p = 0.03) and lower baseline weight (p = 0.024) were associated with an improved glycemic and weight loss response, respectively. CONCLUSION There is no evidence suggesting a role for the variants studied in response to GLP-1 RA therapy in people with T2DM. However, specific demographic and clinical factors may be related to a better response to treatment with these agents.
Collapse
Affiliation(s)
- Artemis Kyriakidou
- Division of Endocrinology and Metabolism - Diabetes Center, 1st Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Angeliki V Kyriazou
- Division of Endocrinology and Metabolism - Diabetes Center, 1st Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Theocharis Koufakis
- Second Propaedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Yiannis Vasilopoulos
- Department of Biology, Section of Genetics, Cell Biology and Development, University of Patras, Patras, Greece
| | - Iakovos Avramidis
- Diabetes Center, Department of Internal Medicine, G. Papanikolaou General Hospital, Thessaloniki, Greece
| | | | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism - Diabetes Center, 1st Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| |
Collapse
|
2
|
Deftereos SG, Giannopoulos G, Vrachatis DA, Siasos GD, Giotaki SG, Gargalianos P, Metallidis S, Sianos G, Baltagiannis S, Panagopoulos P, Dolianitis K, Randou E, Syrigos K, Kotanidou A, Koulouris NG, Milionis H, Sipsas N, Gogos C, Tsoukalas G, Olympios CD, Tsagalou E, Migdalis I, Gerakari S, Angelidis C, Alexopoulos D, Davlouros P, Hahalis G, Kanonidis I, Katritsis D, Kolettis T, Manolis AS, Michalis L, Naka KK, Pyrgakis VN, Toutouzas KP, Triposkiadis F, Tsioufis K, Vavouranakis E, Martinèz-Dolz L, Reimers B, Stefanini GG, Cleman M, Goudevenos J, Tsiodras S, Tousoulis D, Iliodromitis E, Mehran R, Dangas G, Stefanadis C. Effect of Colchicine vs Standard Care on Cardiac and Inflammatory Biomarkers and Clinical Outcomes in Patients Hospitalized With Coronavirus Disease 2019: The GRECCO-19 Randomized Clinical Trial. JAMA Netw Open 2020; 3:e2013136. [PMID: 32579195 PMCID: PMC7315286 DOI: 10.1001/jamanetworkopen.2020.13136] [Citation(s) in RCA: 287] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Severe acute respiratory syndrome coronavirus 2 infection has evolved into a global pandemic. Low-dose colchicine combines anti-inflammatory action with a favorable safety profile. OBJECTIVE To evaluate the effect of treatment with colchicine on cardiac and inflammatory biomarkers and clinical outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19). DESIGN, SETTING, AND PARTICIPANTS In this prospective, open-label, randomized clinical trial (the Greek Study in the Effects of Colchicine in COVID-19 Complications Prevention), 105 patients hospitalized with COVID-19 were randomized in a 1:1 allocation from April 3 to April 27, 2020, to either standard medical treatment or colchicine with standard medical treatment. The study took place in 16 tertiary hospitals in Greece. INTERVENTION Colchicine administration (1.5-mg loading dose followed by 0.5 mg after 60 min and maintenance doses of 0.5 mg twice daily) with standard medical treatment for as long as 3 weeks. MAIN OUTCOMES AND MEASURES Primary end points were (1) maximum high-sensitivity cardiac troponin level; (2) time for C-reactive protein to reach more than 3 times the upper reference limit; and (3) time to deterioration by 2 points on a 7-grade clinical status scale, ranging from able to resume normal activities to death. Secondary end points were (1) the percentage of participants requiring mechanical ventilation, (2) all-cause mortality, and (3) number, type, severity, and seriousness of adverse events. The primary efficacy analysis was performed on an intention-to-treat basis. RESULTS A total of 105 patients were evaluated (61 [58.1%] men; median [interquartile range] age, 64 [54-76] years) with 50 (47.6%) randomized to the control group and 55 (52.4%) to the colchicine group. Median (interquartile range) peak high-sensitivity cardiac troponin values were 0.0112 (0.0043-0.0093) ng/mL in the control group and 0.008 (0.004-0.0135) ng/mL in the colchicine group (P = .34). Median (interquartile range) maximum C-reactive protein levels were 4.5 (1.4-8.9) mg/dL vs 3.1 (0.8-9.8) mg/dL (P = .73), respectively. The clinical primary end point rate was 14.0% in the control group (7 of 50 patients) and 1.8% in the colchicine group (1 of 55 patients) (odds ratio, 0.11; 95% CI, 0.01-0.96; P = .02). Mean (SD) event-free survival time was 18.6 (0.83) days the in the control group vs 20.7 (0.31) in the colchicine group (log rank P = .03). Adverse events were similar in the 2 groups, except for diarrhea, which was more frequent with colchicine group than the control group (25 patients [45.5%] vs 9 patients [18.0%]; P = .003). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, participants who received colchicine had statistically significantly improved time to clinical deterioration. There were no significant differences in high-sensitivity cardiac troponin or C-reactive protein levels. These findings should be interpreted with caution. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04326790.
Collapse
Affiliation(s)
- Spyridon G. Deftereos
- Second Department of Cardiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Gerasimos D. Siasos
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotiria G. Giotaki
- Second Department of Cardiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Simeon Metallidis
- First Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Sianos
- First Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Periklis Panagopoulos
- Second Department of Internal Medicine, General Hospital of Alexandroupoli, Democritus University of Thrace, Alexandroupoli, Greece
| | - Konstantinos Dolianitis
- Department of Internal Medicine, Mpodosakio General Hospital of Ptolemaida, Ptolemaida, Greece
| | - Efthalia Randou
- Department of Internal Medicine, General Hospital of Kozani, Kozani, Greece
| | - Konstantinos Syrigos
- Third Department of Internal Medicine, General Hospital Sotiria, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- First Intensive Care Unit, General Hospital Evangelismos, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos G. Koulouris
- First Department of Pneumonology, General Hospital Sotiria, National and Kapodistrian University of Athens, Athens, Greece
| | - Haralampos Milionis
- First Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - Nikolaos Sipsas
- Infectious Diseases Unit, Laiko General Hospital, Athens, Greece
| | - Charalampos Gogos
- Internal Medicine Department, University Hospital of Patras, Patras, Greece
| | - George Tsoukalas
- Fourth Department of Pneumonology, General Hospital Sotiria, Athens, Greece
| | | | | | - Ilias Migdalis
- Second Medical Department, NIMTS Hospital, Athens, Greece
| | - Styliani Gerakari
- Department of Internal Medicine, General Hospital of West Attica Agia Varvara, Athens, Greece
| | - Christos Angelidis
- Second Department of Cardiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Alexopoulos
- Second Department of Cardiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Pericles Davlouros
- Department of Cardiology, University of Patras Medical School, Patras, Greece
| | - George Hahalis
- Department of Cardiology, University of Patras Medical School, Patras, Greece
| | - Ioannis Kanonidis
- Second Department of Cardiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Theofilos Kolettis
- Department of Cardiology, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - Antonios S. Manolis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lampros Michalis
- Department of Cardiology, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - Katerina K. Naka
- Department of Cardiology, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - Vlasios N. Pyrgakis
- Department of Cardiology, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Konstantinos P. Toutouzas
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Konstantinos Tsioufis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Vavouranakis
- Third Department of Cardiology, General Hospital Sotiria, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Bernhard Reimers
- Cardio Center, Humanitas Clinical and Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Giulio G. Stefanini
- Cardio Center, Humanitas Clinical and Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Michael Cleman
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - John Goudevenos
- Department of Cardiology, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Iliodromitis
- Second Department of Cardiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - George Dangas
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christodoulos Stefanadis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Athens Medical Center, Athens, Greece
| | | |
Collapse
|