Journal
DIABETES RESEARCH AND CLINICAL PRACTICE
Volume 183, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.diabres.2021.109146
Keywords
SGLT-2 inhibitors; GLP-1 receptor agonists; Cardiovascular disease; Renal outcomes; Albuminuria; Diabetes mellitus
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Funding
- Japan Society for the Promotion of Science, Salt Science Research Foundation [20C4]
- Uehara Memorial Foundation
- Yokohama Foundation for Advancement of Medical Science
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In T2DM patients with/without albuminuria, SGLT-2 inhibitors showed superior renal outcomes compared to GLP-1 RAs, while there was no significant difference in the risk of MACE between the two drug classes.
Aims: It remains unclear which sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are most effective for preventing cardiovascular and renal events in type 2 diabetes mellitus (T2DM) patients, depending on the presence of albuminuria. We conducted a network meta-analysis to compare the efficacy of these two drug classes in T2DM patients with/without albuminuria. Methods: We searched the Medline, EMBASE, Cochrane Library databases, and gray literature up to April 20, 2021. We included randomized controlled trials that reported the risk of major adverse cardiovascular events (MACE) and composite of renal outcomes in T2DM. Results: A total of nine studies (81,206 patients) were included. In patients with/without albuminuria, SGLT-2 inhibitors did not significantly reduce the risk of MACE compared with GLP-1 RAs (risk ratio [RR] [95% confidence interval]; 0.96 [0.82-1.12] and 0.94 [0.81-1.10], respectively). In contrast, compared with GLP-1 RAs, SGLT-2 inhibitors were associated with significantly lower renal risk in both patients with/without albuminuria (RR [95% CI]; 0.75 [0.63-0.89] and 0.59 [0.44-0.79], respectively). Conclusions: SGLT-2 inhibitors may be superior to GLP-1 RAs for renal outcomes in T2DM patients with/without albuminuria, although there was no difference in the risk of MACE. (c) 2021 Elsevier B.V. All rights reserved.
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