Effect of preceding drug therapy on the renal and cardiovascular outcomes of combined sodium‐glucose cotransporter‐2 inhibitor and glucagon‐like peptide ‐1 receptor agonist treatment in patients with type 2 diabetes and chronic kidney disease
Authors' conclusion
Although the renal composite outcome did not differ between the two groups, the win ratio of the GLP-1RA-first group versus the SGLT2 inhibitor-first group was significant. These results suggest that, in GLP-1RA and SGLT2 inhibitor combination therapy, the addition of an SGLT2 inhibitor to baseline GLP-1RA treatment may lead to more favourable renal outcomes.
Study context
- Population
- Patients with T2D and chronic kidney disease (CKD) on SGLT2i + GLP-1RA combination therapy, from the 643 T2D patients of the RECAP study132 per group propensity score (PS)-matched
- Participants
- 438 patients
- Comparison
- GLP-1RA first vs SGLT2 inhibitor first, before SGLT2i + GLP-1RA combination therapy
- GLP-1RA-firstn = 223
- SGLT2 inhibitor-firstn = 215reference
- Primary endpoint
- Composite renal outcome:
- Progression to macroalbuminuria
- ≥50% decrease in estimated glomerular filtration rate (eGFR)
Methodological detailspropensity-score matched
- Propensity-score matched
Primary result
Composite renal outcome
Odds ratio
1.80
95% CI 0.85–4.26
P = 0.12
By group
Between GLP-1RA-first and SGLT2 inhibitor-first
OR 1.80 (95% CI 0.85–4.26); P = 0.12
As reported in the abstract
Further findings
| Outcome | Win ratio (95% CI) | P value | |
|---|---|---|---|
| Win ratio for weighted composite renal outcomes (both eGFR ≥50% decrease and macroalbuminuria; eGFR decrease only; macroalbuminuria only) | 1.83 (1.71–1.95) | P < 0.001 | |
| 0.512Win ratio (log scale) |
Original publication
Effect of preceding drug therapy on the renal and cardiovascular outcomes of combined sodium‐glucose cotransporter‐2 inhibitor and glucagon‐like peptide ‐1 receptor agonist treatment in patients with type 2 diabetes and chronic kidney disease. Diabetes Obes Metab. Published 19 May 2024. doi:10.
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