Characteristics predicting the efficacy of SGLT-2 inhibitors versus GLP-1 receptor agonists on major adverse cardiovascular events in type 2 diabetes mellitus: a meta-analysis study
Authors' conclusion
Because decreased eGFR [significant] and albuminuria [trend] were found to predict a better efficacy for SGLT-2i in 3P-MACE reduction, this class of drug should be preferred in such patients. However, GLP-1RA may be considered for patients with normal eGFR because it showed better efficacy than SGLT-2i in this subgroup [trend].
Study context
- Population
- Subjects with T2D in SGLT2i or GLP-1 RA randomised cardiovascular outcome trials (PubMed, Cochrane CENTRAL, EMBASE, 2008–2022)
- Participants
- 111,565 subjects13 trials
- Comparison
- SGLT2i vs GLP-1 RA efficacy on 3P-MACE by baseline characteristics
- Outcome
- ARR and RRR for 3P-MACE by baseline characteristics (age, sex, BMI, HbA1c, eGFR, albuminuria, preexisting CVD, HF)
Methodological detailsmeta-regression, random-effects model, subgroup meta-analysis
- Meta-regression
- Random-effects model
- Subgroup meta-analysis
Pooled result
As reported in the abstract
3P-MACE ARR by baseline characteristics
SGLT-2i ARR, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m²
- 0.90 [−1.44 to - 0.37] events/100 person-years
SGLT-2i ARR, normal renal function
- 0.17 [−0.34 to - 0.01] events/100 person-years
Original publication
Characteristics predicting the efficacy of SGLT-2 inhibitors versus GLP-1 receptor agonists on major adverse cardiovascular events in type 2 diabetes mellitus: a meta-analysis study. Cardiovasc Diabetol. Published 28 June 2023. doi:10.
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