Real-world effectiveness of adding newer generation GLP-1RA to SGLT2i in type 2 diabetes
Authors' conclusion
Combination of SGLT2i and GLP-1RA achieved significantly better cardiometabolic outcomes compared with SGLT2i alone; this supports the hypothesis that the cardioprotective benefits of GLP-1RA and SGLT2i may be additive.
Study context
- Population
- US adults with T2D receiving SGLT2i, Komodo's Healthcare Map, January 1, 2017 to June 30, 2023; 3 cohorts: T2D with atherosclerotic cardiovascular disease (ASCVD), T2D, T2D with chronic kidney disease (CKD)3 cohorts
- Participants
- 100,455 vs 339,540
- Exposure
- Newer generation GLP-1 RA plus SGLT2i vs SGLT2i alone
- Combinationn = 100,455
- SGLT2in = 339,540reference
- Outcome
- CV outcomes in T2D with ASCVD cohort
Methodological detailsentropy balancing
- Entropy balancing
Main finding
As reported in the abstract
Lower risk of ischemic stroke with combination vs SGLT2i alone (significant)
42%
Lower risk of myocardial infarction (MI) with combination vs SGLT2i alone (significant)
37%
Lower risk of 3-point major adverse cardiovascular event (MACE) with combination vs SGLT2i alone (significant)
46%
Lower risk of 5-point MACE with combination vs SGLT2i alone (significant)
45%
Observational data: associations, not effects.
Further findings
Individual GLP-1 RAs: Cardiovascular (CV) risk, HbA1c and weight outcomes
- Largest reductions in CV risk, HbA1c and weight with SGLT2i plus once weekly semaglutide for T2D
- T2D cohort: combination n=8,220, SGLT2i n=22,891; T2D with CKD cohort: combination n=8,783, SGLT2i n=35,532
Original publication
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