Vivian Fonseca, MD

Vivian Fonseca, MD
 

Professor of Medicine and Pharmacology
Tullis Tulane Alumni Chair in Diabetes
Chief, Section of Endocrinology
Tulane University Health Sciences Center
Past President, Science and Medicine
American Diabetes Association


What is the foundational importance of the LEADER trial and what makes it different and, perhaps, more significant than previous trials evaluating strategies for CV risk reduction in T2D?

What is the foundational importance of the LEADER trial and what makes it different and, perhaps, more significant than previous trials evaluating strategies for CV risk reduction in T2D?

Can you drill down into the results of LEADER, including primary end points and breakdown of MACE events? What did we learn about the dose of liraglutide required for CV outcome improvement?

Can you drill down into the results of LEADER, including primary end points and breakdown of MACE events? What did we learn about the dose of liraglutide required for CV outcome improvement?

What did we learn about glycemic control achieved with liraglutide in LEADER? Might the differences in glycemic exposure and other metabolic factors explain the reduction on kidney disease?

What did we learn about the degree of glycemic control achieved with liraglutide in the LEADER trial? And might the differences in glycemic exposure and other metabolic factors explain the reduction on kidney disease?

Since the reduction in non-fatal MI in the LEADER trial was not significant enough to explain the impressive 22% in CV mortality, what factors do you think might have played a role?

Since the reduction in non-fatal MI in the LEADER trial was not significant enough to explain the impressive 22% in CV mortality, what factors do you think might have played a role?

Given the therapies -- statins, SGLT2 inhibitors, antihypertensive agents, etc. -- we can use to reduce CV risk in T2D patients, where do you see liraglutide fitting in based on LEADER?

Given the multiple diabetes- and non-diabetes-focused therapies — statins, SGLT2 inhibitors, antihypertensive agents, etc. — we can use to reduce CV risk in patients with T2D, where do you see liraglutide fitting in based on LEADER?

What are the clinical implications of the fact that liraglutide’s benefits were seen in a high risk population that was already on maximal therapy for CV risk reduction?

What are the clinical implications of the fact that liraglutide’s benefits were seen in a high risk population that was already on maximal therapy for CV risk reduction?

Why do clinicians managing patients with T2D need to be aware of the trials, physiologic basis, side effects and other dimensions of deploying fixed ratio, long-acting insulin-GLP-1 RA combination regimens?

Why do clinicians managing patients with T2D need to be aware of the trials, physiologic basis, side effects and other dimensions of deploying fixed ratio, long-acting insulin-GLP-1 RA combination regimens?

Are there significant clinical differences—pharmacokinetic, safety, degree of weight loss, control of PPG—between the two combination formulations, i.e. glargine insulin plus lixisenatide (iGlarLixi) vs. degludec insulin plus liraglutide (iDegLira)?

Are there significant clinical differences—pharmacokinetic, safety, degree of weight loss, control of PPG—between the two combination formulations, i.e. glargine insulin plus lixisenatide (iGlarLixi) vs. degludec insulin plus liraglutide (iDegLira)?

From a translational perspective, who are the ideal patient candidates for the fixed ratio, combination formulations, i.e. glargine insulin plus lixisenatide (iGlarLixi) vs. degludec insulin plus liraglutide (iDegLira)?

From a translational perspective, who are the ideal patient candidates for the fixed ratio, combination formulations, i.e. glargine insulin plus lixisenatide (iGlarLixi) vs. degludec insulin plus liraglutide (iDegLira)?

What insights have we gained about drug-based management of the diabetic heart?

What insights have we gained about drug-based management of the diabetic heart?

What is your current perspective on the LEADER Trial and how should we translate its findings to the front lines of diabetes care? Can you describe the trial design?

What is your current perspective on the LEADER Trial and how should we translate its findings to the front lines of diabetes care? Can you describe the trial design?

How do slow dose titration strategies for the fixed ratio, combination formulations, i.e. glargine insulin plus lixisenatide (iGlarLixi) vs. degludec insulin plus liraglutide (iDegLira) potentially affect the side effects seen?

How do slow dose titration strategies for the fixed ratio, combination formulations, i.e. glargine insulin plus lixisenatide (iGlarLixi) vs. degludec insulin plus liraglutide (iDegLira) potentially affect the side effects seen?