Sex differences in the efficacy of GLP ‐1 receptor agonists: A systematic review and meta‐analysis of cardiovascular and renal outcome trials
Authors' conclusion
GLP-1RAs reduce the risk of major cardiovascular, kidney, and cerebrovascular outcomes in both sexes, with consistent benefits across men and women. While variations between sexes were observed in certain outcomes, these differences did not reach statistical significance for interaction.
Study context
- Population
- Patients with T2D and related comorbidities in RCTs and secondary analyses reporting sex-stratified data
- Participants
- 85,273 patients11 trials
- Comparison
- GLP-1 RA vs placebo, by sex
- GLP-1RAsn = 43, 339
- Placebon = 41, 934reference
- Outcome
- Composite kidney outcomes, by sex
Methodological detailsrandom-effects models, sex-stratified data
- Random-effects models
- Sex-stratified data
Pooled result
As reported in the abstract
GLP-1RAs vs PlaceboEstimate (95% CI)
20% reduction in males
HR (males) 0.80(0.69–0.92)
31% reduction in females
HR (females) 0.69(0.54–0.87)
- No significant sex interaction
- P = 0.31
Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| 3-point MACE, by sexGLP-1RAsvs Placebo14% reduction in males | HR (males) 0.86 (95% CI 0.79–0.93) | ||
| 3-point MACE, by sexGLP-1RAsvs Placebo18% reduction in females | HR (females) 0.82 (95% CI 0.75–0.90) | P = 0.47 | |
| 0.512Ratio (log scale) |
Stroke, by sex
- Stroke risk reduction in males
- 21%
- Stroke risk reduction in females
- 25%
CV death, MI, hospitalization for heart failure (HHF)
- No significant sex-based differences for CV death, MI or HHF
Original publication
Sex differences in the efficacy of GLP ‐1 receptor agonists: A systematic review and meta‐analysis of cardiovascular and renal outcome trials. Diabetes Obes Metab. Published 11 September 2025. doi:10.
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