Cardiovascular and mortality outcomes with GLP-1 receptor agonists vs other glucose-lowering drugs in individuals with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes: a large population-based matched cohort study
Authors' conclusion
In individuals with NAFLD and type 2 diabetes, GLP-1RAs are associated with lower incidences of adverse CVEs and all-cause mortality compared with metformin or other second- and third-line glucose-lowering medications. However, there was no significant difference in adverse CVEs or all-cause mortality when compared with those taking SGLT2 inhibitors.
Study context
- Population
- Patients >20 years with NAFLD and T2D newly treated with glucose-lowering drugs 1 January 2013–31 December 2021, followed until 30 September 2022
- Participants
- 2,835,398 patients
- Exposure
- GLP-1 RA vs SGLT2 inhibitors; GLP-1 RA vs other second- or third-line glucose-lowering medications
- Outcome
- New onset of adverse cardiovascular events (CVEs): HF, major adverse cardiovascular events (MACE) (unstable angina, MI, coronary procedures or surgeries) and composite cerebrovascular events
Methodological details1:1 propensity matching, TriNetX
- 1:1 propensity matching
- TriNetX
Main finding
As reported in the abstract
New-onset adverse CVEs
Hazard ratio (95% CI)
GLP-1RAsvs SGLT2 inhibitorsHF
0.97(0.93–1.01)
GLP-1RAsvs SGLT2 inhibitorsMACE
0.95(0.90–1.01)
GLP-1RAsvs SGLT2 inhibitorscerebrovascular events
0.99(0.94–1.03)
GLP-1RAsvs Other second- or third-line glucose-lowering medicationsHF
0.88(0.85–0.92)
GLP-1RAsvs Other second- or third-line glucose-lowering medicationsMACE
0.89(0.85–0.94)
GLP-1RAsvs Other second- or third-line glucose-lowering medicationscerebrovascular events
0.93(0.89–0.96)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause mortality, GLP-1RAsvs other second- or third-line glucose-lowering medicationsPropensity-matched | 0.70 (0.66–0.75) | |
| 0.512Hazard ratio (log scale) |
Sensitivity analyses
- Similar results across sensitivity analyses
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Cardiovascular and mortality outcomes with GLP-1 receptor agonists vs other glucose-lowering drugs in individuals with NAFLD and type 2 diabetes: a large population-based matched cohort study. Diabetologia. Published 20 December 2023. doi:10.
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