Comparative analysis on renal and cardiovascular outcomes of antidiabetic treatment in chronic kidney disease patients—A systematic review and network meta‐analysis
Authors' conclusion
SGLT2 inhibitors followed by GLP-1 RA provide strong benefits for CV and kidney health in patients with T2DM and CKD. SGLT2 inhibitors demonstrate superior benefit over GLP-1 receptor agonists for HF and renal outcomes, highlighting their preferred role in these clinical scenarios.
Study context
- Population
- Patients with T2D and chronic kidney disease (CKD)
- Participants
- 143,296 patients26 studies
- Comparison
- SGLT2i vs GLP-1 RA vs DPP-4i
- Outcome
- (1) MACE, (2) composite renal outcomes, (3) all-cause mortality
Methodological detailsRandomized controlled trials (RCTs) published 2014–2024
- RCTs published 2014–2024
Pooled result
As reported in the abstract
SGLT2 inhibitors, composite renal events (P-score)
0.94
SGLT2 inhibitors, major adverse CV events (MACE) (P-score)
0.93
SGLT2 inhibitors and GLP-1 RA, all-cause mortality (P-score)
0.83
Further pooled results
Estimated glomerular filtration rate (eGFR) decline >40% or renal replacement therapy, heart failure (HF) (P-scores)
- SGLT2 inhibitors, eGFR decline >40% or renal replacement therapy (P-score)
- 0.99
- SGLT2 inhibitors, HF (P-score)
- 1.00
MI, macroalbuminuria, stroke (P-scores)
- GLP-1 RA, MI (P-score)
- 0.87
- GLP-1 RA, macroalbuminuria (P-score)
- 0.86
- GLP-1 RA, stroke (P-score)
- 0.83
- GLP-1 RA particularly effective vs SGLT2 inhibitors
Original publication
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