Cardiovascular, Kidney, and Safety Outcomes With GLP-1 Receptor Agonists Alone and in Combination With SGLT2 Inhibitors in Type 2 Diabetes: A Systematic Review and Meta-Analysis
A meta-analysis found that GLP-1 receptor agonists lower heart and kidney complications in type 2 diabetes to a similar degree whether or not patients are also taking an SGLT2 inhibitor, suggesting the two drug classes work independently and add up.
Background
GLP-1 receptor agonists and SGLT2 inhibitors both improve cardiovascular and kidney outcomes in type 2 diabetes, but whether GLP-1 receptor agonist benefits persist when added to an SGLT2 inhibitor was uncertain. This meta-analysis pooled randomized, double-blind, placebo-controlled outcome trials reporting effects by baseline SGLT2 inhibitor use.
Key findings
Across three trials with 17,072 participants (10.2% on an SGLT2 inhibitor at baseline), GLP-1 receptor agonists reduced major adverse cardiovascular events by 21% (HR 0.79), with no heterogeneity by SGLT2 inhibitor use. Effects on heart failure hospitalization (HR 0.58 vs 0.73), the composite kidney outcome (RR 0.79), and eGFR slope were likewise consistent regardless of background SGLT2 inhibitor therapy.
Clinical implications
The cardiovascular and kidney benefits of GLP-1 receptor agonists appear independent of SGLT2 inhibitor use, supporting clinical-practice-guideline recommendations to use these agents in combination for cardiorenal-metabolic protection.
Safety
Serious adverse events and severe hypoglycemia were similar regardless of background SGLT2 inhibitor use, with no evidence of an unfavorable interaction between the two drug classes.
Category
Research
Source
Circulation
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