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Pharmaceuticals
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Advancements in Cardiovascular and Antidiabetic Drug Therapy, 2nd Edition
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Advancements in Cardiovascular and Antidiabetic Drug Therapy, 2nd Edition

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 2872

Special Issue Editor

Dr. Alfredo Caturano

E-Mail Website
Guest Editor
Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
Interests: diabetes; diabetes complications; cardiovascular disease; MASLD; Brugada syndrome; arrhythmias
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular diseases (CVDs) persist as the leading cause of global mortality, claiming 17.9 million lives in 2019, constituting 32% of all global deaths. A staggering 85% of these fatalities were attributed to heart attacks and strokes. Notably, the prevalence of diabetes significantly contributes to these statistics, affecting an estimated 422 million individuals worldwide, with 1.5 million deaths directly linked to diabetes annually.

As vigilant witnesses to the ongoing innovations in cardiovascular care, we have observed significant progress, especially in the realm of drug therapy. The introduction of sodium–glucose cotransporter 2 inhibitors has emerged as a transformative approach for addressing both heart failure and diabetes. Additionally, novel lipid-lowering agents, such as PCSK9 inhibitors and obeticholic acid, have revolutionized cardiovascular prevention. These pharmacological breakthroughs, among others, underscore the dynamic evolution of cardiovascular drug therapy.

In recognition of the pivotal role of drug therapy in shaping the future of cardiovascular and antidiabetic treatments, the journal Pharmaceuticals is thrilled to announce the launch of a Special Issue titled “Advancements in Cardiovascular and Antidiabetic Drug Therapy”. This initiative aims to assemble accurate and current scientific insights focused on drug-based approaches for CVDs and diabetic diseases. I am honored to extend a personal invitation to you and your esteemed co-workers to contribute to this Special Issue by submitting original research articles, systematic reviews and review articles that delve into new ideas and recent advances in the realm of cardiovascular and antidiabetic drug therapy.

Your valuable contributions will undoubtedly shape the trajectory of drug-based interventions, advancing our understanding and capabilities in the treatment landscape. We look forward to receiving your submissions and appreciate your commitment to advancing the frontiers of medical science.

Dr. Alfredo Caturano
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmaceuticals is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular diseases
  • antidiabetic drugs
  • pharmacological interventions
  • sodium–glucose cotransporter 2 inhibitors
  • PCSK9 inhibitors
  • obeticholic acid
  • lipid-lowering agents
  • heart failure treatment
  • diabetes management
  • drug therapy innovations

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Related Special Issue

Published Papers (4 papers)

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Research

12 pages, 630 KiB  
Article
Real-World Analysis of Short-Term Effectiveness of Oral Semaglutide: Impact on Glycometabolic Control and Cardiovascular Risk
by Sara Palazzi, Federica Sentinelli, Antonella Zugaro, Sara Morgante, Livia Santarelli, Sandra Melanzi, Annamaria De Mutiis, Deamaria Piersanti, Barbara Macerola, Marco Iezzi, Pietro Mercuri, Alessandro Ferranti, Daniele Tienforti, Maria Gisella Cavallo, Arcangelo Barbonetti and Marco Giorgio Baroni
Pharmaceuticals 2025, 18(6), 856; https://doi.org/10.3390/ph18060856 - 8 Jun 2025
Viewed by 697
Abstract
Background: Oral semaglutide, a GLP1-receptor agonist (GLP1-RA), shows promise in efficacy and compliance, especially amid the global shortage of injectable GLP-1 RAs. Its short-term effectiveness remains unexplored. Objective: This real-world observational study assessed the short-term effectiveness of oral semaglutide after three [...] Read more.
Background: Oral semaglutide, a GLP1-receptor agonist (GLP1-RA), shows promise in efficacy and compliance, especially amid the global shortage of injectable GLP-1 RAs. Its short-term effectiveness remains unexplored. Objective: This real-world observational study assessed the short-term effectiveness of oral semaglutide after three months of therapy. Methods: Patients with type 2 diabetes from four Italian diabetes centers, who received an initial prescription of oral semaglutide, were reassessed after three months. Primary outcomes included glycated hemoglobin (HbA1c) and body weight reduction; secondary outcomes involved changes in lipid parameters and cardiovascular risk. Results: Among 167 participants (mean age 66.5 years, mostly obese, baseline HbA1c 8.4% ± 1.5), 83.2% received a 7 mg dose. After three months, HbA1c significantly declined (8.4% to 7.1%, −1.3%, p < 0.001), alongside body mass index (BMI) (30.9 kg/m2 to 29.6 kg/m2, p < 0.0001). The target HbA1c ≤ 7% was achieved by 54.5%, and 34.7% reached ≤6.5%. Patients losing >5% of their initial weight (30.5%) saw the largest HbA1c drop (−1.9%). Those with newly diagnosed diabetes or a duration < 5 years showed superior responses (p = 0.001), while no significant differences were found based on the timing of drug administration. Oral semaglutide replaced or supplemented prior therapies, allowing discontinuation of dipeptidyl peptidase 4 inhibitors (DPP4i), sulfonylureas, glinides, and acarbose, and deprescription of thiazolidinediones. A significant reduction in cardiovascular risk was observed (p = 0.04), together with a significant reduction in lipid parameters. Conclusions: Oral semaglutide showed significant short-term efficacy, reducing HbA1c, body weight, and cardiovascular risk in three months, making it a valuable therapeutic option. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular and Antidiabetic Drug Therapy, 2nd Edition)
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17 pages, 1552 KiB  
Article
The Effect of Metformin on Pituitary Function in Postmenopausal Women with Subclinical Hypothyroidism and Macroprolactinemia: A Single-Center Prospective Case–Control Study
by Robert Krysiak, Witold Szkróbka, Karolina Kowalcze and Bogusław Okopień
Pharmaceuticals 2025, 18(6), 834; https://doi.org/10.3390/ph18060834 - 2 Jun 2025
Viewed by 457
Abstract
Background/Objectives: Metformin inhibits secretory function of overactive thyrotrophs, gonadotrophs, and lactotrophs. The clinical significance of an excess of high-molecular-weight prolactin (macroprolactinemia) remains unclear. The aim of the current study was to investigate for the first time whether macroprolactinemia determines the pituitary effects of [...] Read more.
Background/Objectives: Metformin inhibits secretory function of overactive thyrotrophs, gonadotrophs, and lactotrophs. The clinical significance of an excess of high-molecular-weight prolactin (macroprolactinemia) remains unclear. The aim of the current study was to investigate for the first time whether macroprolactinemia determines the pituitary effects of this drug. Methods: This single-center prospective case–control study included two groups of postmenopausal women with subclinical hypothyroidism, who were matched for age, insulin sensitivity, and plasma concentrations of gonadotropins and TSH. Group A enrolled women with normal prolactin status, while group B included women with macroprolactinemia. Owing to concomitant type 2 diabetes or prediabetes, all the participants received metformin for six months. The outcomes of interest included glucose homeostasis markers (fasting glucose, glycated hemoglobin, and HOMA-IR), plasma prolactin (total and monomeric), macroprolactin, other pituitary hormones (FSH, LH, TSH, and ACTH), and peripheral hormones (estradiol, free thyroid hormones, and IGF-1). Results: Before metformin treatment, the study groups differed only in concentrations of total prolactin and macroprolactin. Metformin decreased FSH and TSH and tended to decrease LH only in group A, and the strength of this effect showed correlations with the baseline levels of these hormones, the degree of improvement in insulin sensitivity, and the macroprolactin content (only in group B). The decrease in fasting glucose, glycated hemoglobin, and HOMA-IR was more pronounced in group A than group B. There were no differences between the pretreatment and posttreatment values of total prolactin, monomeric prolactin, macroprolactin, ACTH, estradiol, free thyroid hormones, and IGF-1. Conclusions: The obtained results suggest that macroprolactinemia may counteract the pituitary effects of metformin. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular and Antidiabetic Drug Therapy, 2nd Edition)
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14 pages, 1161 KiB  
Article
The Effects of Inclisiran on the Subclinical Inflammatory Markers of Atherosclerotic Cardiovascular Disease in Patients at High Cardiovascular Risk
by Mateusz Maligłówka, Adrianna Dec, Łukasz Bułdak and Bogusław Okopień
Pharmaceuticals 2025, 18(6), 832; https://doi.org/10.3390/ph18060832 - 1 Jun 2025
Viewed by 657
Abstract
Background/Objectives: Hypercholesterolemia, accompanied by vascular inflammation, leads to the premature initiation and progression of atherosclerosis, and both are considered nowadays as well-established cardiovascular (CV) risk factors. For several years, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is), drugs that reduce the degradation of the [...] Read more.
Background/Objectives: Hypercholesterolemia, accompanied by vascular inflammation, leads to the premature initiation and progression of atherosclerosis, and both are considered nowadays as well-established cardiovascular (CV) risk factors. For several years, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is), drugs that reduce the degradation of the receptors for low-density lipoprotein cholesterol (LDLRs), have appeared to be a very efficient lipid-lowering therapy among patients with complications resulting from atherosclerotic cardiovascular disease (ASCVD). Previous studies showed that drugs used to fight hypercholesterolemia (predominantly statins) have significant pleiotropic effects, including anti-inflammatory effects. To date, data on the potential impact of PCSK9 inhibitors, especially inclisiran, on the course of inflammation is still lacking. Therefore, we conceived a study to evaluate the effects of inclisiran on the markers of subclinical inflammation (e.g., pentraxin 3 (PTX3), interleukin-18 (IL-18), and soluble cluster of differentiation 40 ligand (CD40L)) and compared their magnitude in patients at high CV risk, with and without established heterozygous familial hypercholesterolemia (HeFH). Methods: A total of 24 patients at high cardiovascular risk, according to European Society of Cardiology (ESC) guidelines, with or without concomitant HeFH diagnosed using Dutch Lipid Clinic Network (DLCN) criteria, were enrolled in this study. Lipid concentrations and levels of subclinical inflammatory markers of atherosclerosis were measured at the beginning and after 3 months of therapy. Results: After three months of therapy with inclisiran, a statistically significant reduction included total cholesterol (TC): study group 1: from 287.6 ± 94.15 to 215.2 ± 89.08 [mg/dL], p = 0.022 and study group 2: from 211.71 ± 52.72 to 147.64 ± 55.44 [mg/dL], p < 0.001, and low-density lipoprotein cholesterol (LDL-c): study group 1: from 180.79 ± 73.33 to 114.65 ± 71.54 [mg/dL], p = 0.031 and study group 2: from 129.62 ± 46.75 to 63.39 ± 43.6 [mg/dL], p < 0.001. Moreover significant drops were observed in concentrations of PTX3: study group 1: from 1336.33 ± 395.15 to 1121.75 ± 351.17 [pg/mL], p = 0.013 and study group 2: from 1610.76 ± 537.78 to 1376.92 ± 529.19 [pg/mL], p = 0.017), and IL-18: study group 1: from 11.89 (9.72–13.98) to 9.15 (8.62–10.06) [pg/mL], p = 0.005 and study group 2: from 11.58 (10.87–16.97) to 9.65 (8.43–10.95) [pg/mL], p = 0.003). There were no significant changes in the levels of sCD40L. Conclusions: This study confirmed the ability of inclisiran to reduce LDL-c levels in patients at high cardiovascular risk just after one dose of the drug. Furthermore, it appeared that beyond its lipid-lowering effect, the drug may also affect some inflammatory processes involved in the initiation and progression of atherosclerosis. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular and Antidiabetic Drug Therapy, 2nd Edition)
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13 pages, 710 KiB  
Article
Evaluating Guideline Alignment by Analyzing Patient Profiles of Elderly People with Type 2 Diabetes and Chronic Kidney Disease Treated or Not with SGLT2 Inhibitors
by Kyriaki Vafeidou, Ourania Psoma, Georgios Dimakopoulos, Evangelos Apostolidis, Anastasia Sarvani, Eleni Gavriilaki, Michael Doumas, Vassilios Tsimihodimos, Kalliopi Kotsa and Theocharis Koufakis
Pharmaceuticals 2025, 18(6), 807; https://doi.org/10.3390/ph18060807 - 27 May 2025
Viewed by 655
Abstract
Background/Objectives: Current guidelines for the management of type 2 diabetes (T2D) strongly recommend the use of sodium–glucose cotransporter 2 inhibitors (SGLT2is) in patients with chronic kidney disease (CKD) to alleviate cardiorenal risk. However, the implementation of this guidance in daily practice remains limited. [...] Read more.
Background/Objectives: Current guidelines for the management of type 2 diabetes (T2D) strongly recommend the use of sodium–glucose cotransporter 2 inhibitors (SGLT2is) in patients with chronic kidney disease (CKD) to alleviate cardiorenal risk. However, the implementation of this guidance in daily practice remains limited. In a real-world setting, we evaluated the frequency of SGLT2i use in elderly people with T2D and CKD and compared patient profiles between SGLT2i users and non-users. Methods: We retrospectively analyzed the medical records of individuals over 65 years of age followed in outpatient internal medicine clinics in Greece. Demographic and laboratory parameters, comorbidity profiles, and medication use were recorded and compared between the SGLT2i and non-SGLT2i groups. Results: The analysis included 135 patients with T2D and CKD, of whom the majority (57.8%) did not receive SGLT2i treatment. The patients in the SGLT2i group were younger (p = 0.006), had higher creatinine (p = 0.001) and hemoglobin (p = 0.001) values, and lower levels of uric acid (p = 0.025) than the participants not treated with SGLT2is. Heart failure rates were similar between the groups (p = 0.252). There was no difference in the use of renin–angiotensin–aldosterone system inhibitors (p = 0.210); in contrast, treatment with glucagon-like peptide 1 receptor agonists was more frequent in the group receiving SGLT2is compared to the group not treated with gliflozins (p = 0.002). Conclusions: Real-world data confirm the benefits of SGLT2i treatment for elderly people with T2D and CKD. However, our findings indicate that the use of gliflozins in this population of patients remains suboptimal, highlighting the need for greater vigilance among prescribers to align with existing guidelines. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular and Antidiabetic Drug Therapy, 2nd Edition)
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