Aim
To test the hypothesis that treatment with liraglutide can reduce cardiac adipose tissue.

Materials and methods
LIRAFLAME is a randomized placebo-controlled, double-blind, parallel clinical study. Participants with type 2 diabetes were randomized to treatment with liraglutide 1.8 mg/d or placebo for 26 weeks. Computed tomography was performed at baseline and at end of treatment to evaluate the cardiac adipose tissue volume, quantified automatically. We report the results of a secondary endpoint evaluating changes in cardiac adipose tissue.

Results
A total of 102 participants were randomly assigned to liraglutide (n = 51) or placebo (n = 51). At baseline, the mean (SD) cardiac adipose tissue volume was comparable between the liraglutide and the placebo group (232.6 [112.8] vs. 227.0 [103.2] mL; P = 0.80). The mean change in body weight was −3.7 (−4.8, −2.6) kg in the liraglutide and −0.18 (−0.76, 0.40) kg in the placebo group. From baseline to end of treatment the mean cardiac adipose tissue change was −11.5 (95% confidence interval −17.6, −5.4) mL in the liraglutide (P < 0.001) and −0.01 (−5.3, 5.3) mL in the placebo (P = 1.00) groups. The reduction in cardiac adipose tissue was significantly greater in the liraglutide compared to the placebo group (mean difference −11.4 [−19.4, −3.3] mL; P = 0.006), but significance was lost after adjustment for changes in body mass index (P = 0.46).

Conclusion
Treatment with liraglutide for 26 weeks was associated with a reduction in cardiac adipose tissue compared to placebo. The reduction was not independent of weight loss, suggesting that this is not a drug-specific effect.