Sex differences in trial representation and the cardiovascular effectiveness of newer glucose‐lowering agents in patients with and without type 2 diabetes: A systematic review and meta‐analysis of cardiovascular outcome trials
Authors' conclusion
SGLT-2is and GLP-1RAs provide broadly comparable cardio-kidney benefits across sexes in patients with and without T2D. The lower representation of women in CVOTs warrants attention.
Study context
- Population
- Patients with and without T2D in cardiovascular outcome trials (CVOTs) of SGLT2i and GLP-1 RA (MEDLINE, Embase, CENTRAL, ClinicalTrials.gov up to August 2025)
- Participants
- > 185,000 patients25 CVOTs
- Comparison
- SGLT2i and GLP-1 RA effects in men vs women
- Outcome
- Sex differences in trial representation and cardiovascular and kidney efficacy of SGLT2i and GLP-1 RA
Methodological detailsrandom-effects meta-analysis, ratio of hazard ratios (HRs) and meta-regression, 47 articles from 25 CVOTs published 2015–2025
- Random-effects meta-analysis
- Ratio of HRs and meta-regression
- 47 articles from 25 CVOTs published 2015–2025
Pooled result
As reported in the abstract
Cardio-kidney outcomes by sex (sex-specific HRs; ratio of HRs)
Hazard ratio (CI)
SGLT-2isMACE; men with T2D
0.87(0.80–0.95)
SGLT-2isCV death or hospitalization for HF; men with T2D
0.73(0.64–0.83)
GLP-1RAsMACE; men with T2D
0.89(0.82–0.96)
GLP-1RAsMACE; women with T2D
0.83(0.77–0.91)
Further pooled results
Representation of women in CVOTs
- Women less represented
- approximately one-third of trial participants
Original publication
Sex differences in trial representation and the cardiovascular effectiveness of newer glucose‐lowering agents in patients with and without type 2 diabetes: A systematic review and meta‐analysis of cardiovascular outcome trials. Diabetes Obes Metab. Published 8 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →