Phenotype-based targeted treatment of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes
Authors' conclusion
Precision medicine approaches can facilitate effective individualised treatment choice between SGLT2i and GLP1-RA therapies, and the use of routinely collected clinical features for treatment selection could support low-cost deployment in many countries.
Study context
- Population
- People with T2D in primary care in England (Clinical Practice Research Datalink); external validation in Scotland (SCI-Diabetes [Tayside & Fife])external validation 2252
- Participants
- 46,394 people
- Comparison
- SGLT2i vs GLP-1 RA
- Outcome
- Individual-level conditional average treatment effects for HbA1c between SGLT2i and GLP1-RA
- Follow-up
- 12-month
Methodological detailsBayesian causal forest, hold-out validation, external validation
- Bayesian causal forest
- Hold-out validation
- External validation
Performance
As reported in the abstract
Predicted HbA1c benefit >3 mmol/mol (>0.3%), development cohort
Predicted benefit with SGLT2i over GLP1-RA
4787
17.5%
Predicted benefit with GLP1-RA over SGLT2i
5551
20.3%
Secondary outcomes
| Outcome | Greater HbA1c response (mmol/mol) (95% CrI) |
|---|---|
| Sex as treatment effect modifier for GLP1-RA response (HARMONY-7 liraglutide)Women vs Men · 0.4% [95% CrI 0.2, 0.6]; greater with women · CrI | 4.4 (2.2–6.3) |
Tolerability and microvascular complications
- Targeting therapy by predicted glycaemic response associated with improved short-term tolerability and long-term risk of new-onset microvascular complications
Original publication
Phenotype-based targeted treatment of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes. Diabetologia. Published 22 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →