4.7 Review

Combining glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with type 2 diabetes mellitus (T2DM)

Related references

Note: Only part of the references are listed.
Article Medicine, General & Internal

Empagliflozin in Patients with Chronic Kidney Disease

William G. Herrington et al.

Summary: Empagliflozin therapy reduces the risk of disease progression or cardiovascular death in patients with chronic kidney disease.

NEW ENGLAND JOURNAL OF MEDICINE (2023)

Article Endocrinology & Metabolism

Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2023

Nuha A. ElSayed et al.

DIABETES CARE (2023)

Article Cardiac & Cardiovascular Systems

Efpeglenatide and Clinical Outcomes With and Without Concomitant Sodium-Glucose Cotransporter-2 Inhibition Use in Type 2 Diabetes: Exploratory Analysis of the AMPLITUDE-O Trial

Carolyn S. P. Lam et al.

Summary: The analysis of the AMPLITUDE-O trial suggests that the efficacy and safety of Efpeglenatide are not impacted by concurrent use of SGLT2 inhibitors. These data support the combined use of SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists in the treatment of type 2 diabetes.

CIRCULATION (2022)

Article Endocrinology & Metabolism

Primary Prevention of Cardiovascular and Heart Failure Events With SGLT2 Inhibitors, GLP-1 Receptor Agonists, and Their Combination in Type 2 Diabetes

Alison K. K. Wright et al.

Summary: This study assessed the associations between sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists with risk for major adverse cardiac and cerebrovascular events (MACCE) and heart failure (HF) in people with type 2 diabetes. The results showed that SGLT2i and SGLT2i/GLP-1RA combination regimens may be beneficial in the prevention of MACCE and HF, while GLP-1RA may be beneficial for HF.

DIABETES CARE (2022)

Article Cardiac & Cardiovascular Systems

Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor Dapagliflozin Stabilizes Diabetes-Induced Atherosclerotic Plaque Instability

Yung-Chih Chen et al.

Summary: This study investigates the effects of diabetes on plaque instability using a tandem stenosis mouse model and streptozotocin-induced diabetes. The results show that diabetic mice exhibit increased plaque instability, while treatment with a sodium-glucose co-transporter 2 inhibitor can reduce glucose and triglyceride levels and promote plaque stabilization.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2022)

Review Pharmacology & Pharmacy

The Efficacy and Safety of the Combination Therapy With GLP-1 Receptor Agonists and SGLT-2 Inhibitors in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

Chen Li et al.

Summary: Combination therapy with glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors has superior effects on reducing HbA1c, body weight, fasting plasma glucose (FPG), 2 h postprandial glucose (2 h PG), systolic blood pressure (SBP), body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes mellitus compared to monotherapy. However, the efficacy of these effects gradually decreases over time and there is an increased risk of hypoglycemia and certain adverse events associated with combination therapy.

FRONTIERS IN PHARMACOLOGY (2022)

Review Biochemistry & Molecular Biology

Cardiovascular and Renal Effectiveness of GLP-1 Receptor Agonists vs. Other Glucose-Lowering Drugs in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Real-World Studies

Irene Caruso et al.

Summary: Real-world studies have shown that GLP-1RA treatment has significant cardiovascular benefits compared to other glucose-lowering drugs, but it is less effective in preventing heart failure.

METABOLITES (2022)

Review Endocrinology & Metabolism

Cardiovascular and mortality outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: A meta-analysis with the FREEDOM cardiovascular outcomes trial

Matthew M. Y. Lee et al.

Summary: This study translated and summarized the results of the FREEDOM trial, which tested a GLP-1 receptor agonist for cardiovascular outcomes. The analysis found that GLP-1 receptor agonists can reduce major adverse cardiovascular events and all-cause mortality, but the results of the FREEDOM trial differ from previous trials.

DIABETES & METABOLIC SYNDROME-CLINICAL RESEARCH & REVIEWS (2022)

Editorial Material Endocrinology & Metabolism

Antiatherosclerotic Effects of Sodium-Glucose Cotransporter 2 Inhibitors: An Underrecognized Piece of the Big Puzzle? Comment

Theocharis Koufakis et al.

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM (2022)

Article Cardiac & Cardiovascular Systems

ADDITIVE CARDIOVASCULAR RISK REDUCTION OF GLP1A AND SGLT2I IN DIABETIC PATIENTS WITH ATHEROSCLEROTIC DISEASE

Persio Lopez Loyo et al.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2022)

Article Cardiac & Cardiovascular Systems

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Paul A. Heidenreich et al.

Summary: This article provides an overview of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure, including its aim, methods, and structure.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2022)

Review Medicine, General & Internal

Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases A Systematic Review and Meta-analysis of Randomized Clinical Trials

Liyun He et al.

Summary: This systematic review and meta-analysis of RCTs found that the use of GLP-1 RAs is associated with an increased risk of gallbladder or biliary diseases, especially at higher doses, for longer durations, and for weight loss.

JAMA INTERNAL MEDICINE (2022)

Article Medicine, General & Internal

Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials

Natalie Staplin et al.

Summary: This study provides evidence that SGLT2 inhibitors can reduce the risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure regardless of diabetes status, primary kidney disease, or kidney function.

LANCET (2022)

Article Cardiac & Cardiovascular Systems

2022 Canadian Cardiovascular Society Guideline for Use of GLP-1 Receptor Agonists and SGLT2 Inhibitors for Cardiorenal Risk Reduction in Adults

G. B. John Mancini et al.

Summary: This guideline provides recommendations for the use of glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter 2 inhibitors in the treatment of heart failure, chronic kidney disease, and prevention of cardiorenal morbidity and mortality in patients with type 2 diabetes. It includes systematic review and meta-analysis of clinical trial data, as well as practical advice for the safe use of these agents.

CANADIAN JOURNAL OF CARDIOLOGY (2022)

Review Medicine, General & Internal

Dipeptidyl peptidase-4 inhibitors and gallbladder or biliary disease in type 2 diabetes: systematic review and pairwise and network meta-analysis of randomised controlled trials

Liyun He et al.

Summary: This study aimed to examine the association between dipeptidyl peptidase-4 inhibitors and gallbladder or biliary diseases, finding a significant increase in the risk of cholecystitis associated with these drugs.

BMJ-BRITISH MEDICAL JOURNAL (2022)

Review Endocrinology & Metabolism

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

Weiting Hu et al.

Summary: The meta-analysis found that the use of GLP-1 receptor agonists was associated with an increased risk of overall thyroid disorders, but had no significant effects on the occurrence of thyroid cancer, hyperthyroidism, hypothyroidism, thyroiditis, thyroid mass, and goiter. Subgroup and meta-regression analyses did not show any significant correlation with underlying diseases, type of control, or trial durations on the effect of GLP-1 receptor agonists on overall thyroid disorders.

FRONTIERS IN ENDOCRINOLOGY (2022)

Article Medicine, General & Internal

First-Line Therapy for Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists A Cost-Effectiveness Study

Jin G. Choi et al.

Summary: This study evaluated the lifetime cost-effectiveness of using SGLT2 inhibitors and GLP1 receptor agonists as first-line therapy for type 2 diabetes. The results showed that while these drugs can improve outcomes for patients, their high costs limit their cost-effectiveness.

ANNALS OF INTERNAL MEDICINE (2022)

Article Cardiac & Cardiovascular Systems

Critical Reanalysis of the Mechanisms Underlying the Cardiorenal Benefits of SGLT2 Inhibitors and Reaffirmation of the Nutrient Deprivation Signaling/Autophagy Hypothesis

Milton Packer

Summary: SGLT2 inhibitors promote cellular housekeeping and enhance cellular protection, leading to reduced progression of cardiomyopathy and nephropathy. Clinical studies suggest that SGLT2 inhibitors enhance nutrient deprivation signaling, resulting in a lower risk of heart failure and serious renal events.

CIRCULATION (2022)

Article Endocrinology & Metabolism

Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Melanie J. Davies et al.

Summary: The American Diabetes Association and the European Association for the Study of Diabetes have updated the consensus statements on the management of hyperglycemia in adults with type 2 diabetes. The new recommendations highlight the importance of social determinants of health, weight management, and provide practical tips for implementation.

DIABETES CARE (2022)

Article Endocrinology & Metabolism

Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)

Ian H. de Boer et al.

Summary: People with diabetes and CKD are at high risk for kidney failure, cardiovascular disease, heart failure, and premature mortality. Recent clinical trials support new approaches to treat these conditions. The ADA and KDIGO provide evidence-based recommendations and consensus statements for clinical care.

DIABETES CARE (2022)

Article Medicine, General & Internal

SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials

Muthiah Vaduganathan et al.

Summary: This study conducted a meta-analysis of the therapeutic effects of SGLT2 inhibitors in heart failure patients, showing that these drugs can significantly reduce the risk of cardiovascular death and hospitalization for heart failure in heart failure patients, demonstrating their importance in foundational treatment.

LANCET (2022)

Review Geriatrics & Gerontology

Hypoglycaemic therapy in frail older people with type 2 diabetes mellitus-a choice determined by metabolic phenotype

Alan J. Sinclair et al.

Summary: Frailty is a newly recognized complication of diabetes in older people, but it lacks clear definition and characterization. Clinical guidelines recommend relaxed glycemic control to avoid hypoglycemia in this vulnerable group. Frailty in older people with diabetes is associated with changes in body composition, including increased visceral fat and decreased muscle mass. Different metabolic phenotypes exist within frailty, such as sarcopenic obesity and anorexic malnutrition, which require different hypoglycemic therapies and goals. More research is needed to develop hypoglycemic agents that positively impact body composition and clinical outcomes in frailty.

AGING CLINICAL AND EXPERIMENTAL RESEARCH (2022)

Article Endocrinology & Metabolism

Primary Prevention of Cardiovascular and Heart Failure Events With SGLT2 Inhibitors, GLP-1 Receptor Agonists, and Their Combination in Type 2 Diabetes

Alison K. Wright et al.

Summary: The study suggests that SGLT2i and SGLT2i/GLP-1RA combination regimens may be beneficial in primary prevention of MACCE and HF, while GLP-1RA appears to be beneficial for HF.

DIABETES CARE (2022)

Review Endocrinology & Metabolism

Practical Considerations and Rationale for Glucagon-Like Peptide-1 Receptor Agonist Plus Sodium-Dependent Glucose Cotransporter-2 Inhibitor Combination Therapy in Type 2 Diabetes

Ronald M. Goldenberg et al.

Summary: The combination of glucagon-like peptide-1 receptor agonists and sodium-dependent glucose cotransporter-2 inhibitors shows promise in managing adults with type 2 diabetes, with significant benefits in controlling glycated hemoglobin, weight, blood pressure and cardiorenal outcomes. Ongoing research is necessary to further explore the potential of this therapeutic combination in various other conditions and populations without diabetes.

CANADIAN JOURNAL OF DIABETES (2021)

Article Endocrinology & Metabolism

Cardiorenal outcomes with dapagliflozin by baseline glucose-lowering agents: Post hoc analyses fromDECLARE-TIMI58

Avivit Cahn et al.

Summary: The effects of dapagliflozin on cardiorenal outcomes were consistent regardless of baseline GLA, with significant benefits observed in patients using GLP-1 RAs. There was no interaction by baseline GLA for the reduction in renal-specific outcome seen with dapagliflozin in the overall cohort. Further exploration into the potential clinical benefit of combining sodium-glucose co-transporter-2 inhibitors with GLP-1 RAs is warranted.

DIABETES OBESITY & METABOLISM (2021)

Article Cardiac & Cardiovascular Systems

Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes A Meta-analysis

Darren K. McGuire et al.

Summary: SGLT2 inhibitors were found to reduce the risk of major adverse CV events and showed significant heterogeneity in associations with CV death. The most consistent benefit of this class of drugs was a reduction in risk for heart failure and kidney outcomes, with heart failure risk reduction being the most consistent observation across the trials.

JAMA CARDIOLOGY (2021)

Article Cardiac & Cardiovascular Systems

Risk of Cardiovascular Outcomes in Patients With Type 2 Diabetes After Addition of SGLT2 Inhibitors Versus Sulfonylureas to Baseline GLP-1RA Therapy

Chintan V. Dave et al.

Summary: The study indicates that adding SGLT2 inhibitors to GLP-1 receptor agonist therapy in patients with type 2 diabetes can provide additional cardiovascular benefits, especially in reducing cardiovascular endpoint events and heart failure hospitalizations.

CIRCULATION (2021)

Article Endocrinology & Metabolism

Combined exenatide and dapagliflozin has no additive effects on reduction of hepatocellular lipids despite better glycaemic control in patients with type 2 diabetes mellitus treated with metformin: EXENDA, a 24-week, prospective, randomized, placebo-controlled pilot trial

Juergen Harreiter et al.

Summary: After 24 weeks of treatment, both the EXE + DAPA and PLAC + DAPA groups showed significant reductions in HCL levels, with better glycemic control in the EXE + DAPA group. Changes in HCL were associated with weight loss and reduction in visceral adiposity, but not with glucose control. Further studies are needed to evaluate the long-term effects of this combined treatment.

DIABETES OBESITY & METABOLISM (2021)

Article Cardiac & Cardiovascular Systems

The association of amputations and peripheral artery disease in patients with type 2 diabetes mellitus receiving sodium-glucose cotransporter type-2 inhibitors: real-world study

Sanjoy K. Paul et al.

Summary: This study evaluated the risk of amputations in patients with type 2 diabetes treated with different anti-diabetic drugs, finding that SGLT-2i and incretins did not increase the risk compared to other ADDs. Pre-existing peripheral artery disease (PAD) was identified as the major driver of amputation risk.

EUROPEAN HEART JOURNAL (2021)

Article Medicine, General & Internal

Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease

Deepak L. Bhatt et al.

Summary: The trial involving 10,584 patients with diabetes and chronic kidney disease showed that sotagliflozin resulted in fewer deaths from cardiovascular causes, hospitalizations for heart failure, and urgent visits for heart failure compared to placebo. However, there were adverse events such as diarrhea, mycotic infections, and diabetic ketoacidosis associated with sotagliflozin.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Editorial Material Cardiac & Cardiovascular Systems

Why Choose Between SGLT2 Inhibitors and GLP1-RA When You Can Use Both? The Time to Act Is Now

Alice Y. Y. Cheng

CIRCULATION (2021)

Review Endocrinology & Metabolism

Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials

Naveed Sattar et al.

Summary: The meta-analysis showed that GLP-1 receptor agonists can reduce the risk of major adverse cardiovascular events, all-cause mortality, hospital admission for heart failure, and worsening kidney function in patients with type 2 diabetes, regardless of structural homology.

LANCET DIABETES & ENDOCRINOLOGY (2021)

Article Cardiac & Cardiovascular Systems

GLP-1 receptor agonists and cardiorenal outcomes in type 2 diabetes: an updated meta-analysis of eight CVOTs

Dario Giugliano et al.

Summary: Glucagon-like peptide-1 receptor agonists have significant benefits on cardiovascular and renal outcomes in patients with type 2 diabetes, including reducing major cardiovascular events, hospitalization for heart failure, all-cause mortality, and the incidence of macroalbuminuria.

CARDIOVASCULAR DIABETOLOGY (2021)

Article Cardiac & Cardiovascular Systems

CAPTURE: a multinational, cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries

Ofri Mosenzon et al.

Summary: The CAPTURE study aimed to estimate the prevalence of established cardiovascular disease in adults with type 2 diabetes across 13 countries from five continents, and to further characterize the study sample regarding demographics, clinical parameters, and medication usage, particularly focusing on glucose-lowering agents with demonstrated cardiovascular benefits.

CARDIOVASCULAR DIABETOLOGY (2021)

Article Medicine, General & Internal

Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes

Hertzel C. Gerstein et al.

Summary: The trial compared the cardiovascular and renal outcomes of weekly injections of efpeglenatide versus a placebo in participants with type 2 diabetes and a history of cardiovascular disease or current kidney disease. The study found that the risk of cardiovascular events was lower with efpeglenatide treatment, and a composite renal outcome event was also reduced.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Review Medicine, General & Internal

Association of glucagon-like peptide 1 analogs and agonists administered for obesity with weight loss and adverse events: a systematic review and network meta-analysis

Kia Vosoughi et al.

Summary: This study conducted a systematic review and network meta-analysis to assess the weight loss effects of 7 GLP-1 agents in obesity. Results showed varying degrees of weight loss with different drugs, with semaglutide agents demonstrating the most significant effects.

ECLINICALMEDICINE (2021)

Article Cardiac & Cardiovascular Systems

The association of amputations and peripheral artery disease in patients with type 2 diabetes mellitus receiving sodium-glucose cotransporter type-2 inhibitors: real-world study

Sanjoy K. Paul et al.

Summary: This study aimed to evaluate the temporal pattern of amputations in T2DM patients, the risk of amputations by different types of anti-diabetic drugs, and the interplay of PAD with therapy and amputation risk. The results showed that the risk of amputation was not higher in patients treated with SGLT-2i and incretins compared to other ADDs, and pre-existing PAD was the greatest driver of amputation risk.

EUROPEAN HEART JOURNAL (2021)

Article Pharmacology & Pharmacy

GLP1 Receptor Agonist and SGLT2 Inhibitor Combination: An Effective Approach in Real-world Clinical Practice

Olaia Diaz-Trastoy et al.

CLINICAL THERAPEUTICS (2020)

Review Pharmacology & Pharmacy

GLP-1 Receptor Agonists in Diabetic Kidney Disease: From Clinical Outcomes to Mechanisms

Daiji Kawanami et al.

FRONTIERS IN PHARMACOLOGY (2020)

Review Endocrinology & Metabolism

GLP-1 receptor agonists in the treatment of type 2 diabetes-state-of-the-art

Michael A. Nauck et al.

MOLECULAR METABOLISM (2020)

Article Medicine, General & Internal

Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes

S. D. Wiviott et al.

NEW ENGLAND JOURNAL OF MEDICINE (2019)

Review Endocrinology & Metabolism

Early worsening of diabetic retinopathy after rapid improvement of blood glucose control in patients with diabetes

S. Feldman-Billard et al.

DIABETES & METABOLISM (2018)

Review Pharmacology & Pharmacy

A comparative safety review between GLP-1 receptor agonists and SGLT2 inhibitors for diabetes treatment

Agostino Consoli et al.

EXPERT OPINION ON DRUG SAFETY (2018)

Article Medicine, General & Internal

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes

Rury R. Holman et al.

NEW ENGLAND JOURNAL OF MEDICINE (2017)

Article Medicine, General & Internal

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes

Bruce Neal et al.

NEW ENGLAND JOURNAL OF MEDICINE (2017)

Article Cardiac & Cardiovascular Systems

Real-world effectiveness and safety of dapagliflozin therapy added to a GLP1 receptor agonist in patients with type 2 diabetes

J. J. Gorgojo-Martinez et al.

NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES (2017)

Review Endocrinology & Metabolism

Combination therapy with GLP-1 receptor agonist and SGLT2 inhibitor

Ralph A. DeFronzo

DIABETES OBESITY & METABOLISM (2017)

Letter Endocrinology & Metabolism

Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors: Sequential or simultaneous start?

Edison Goncalves et al.

DIABETES OBESITY & METABOLISM (2017)

Article Medicine, General & Internal

Effects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction A Randomized Clinical Trial

Kenneth B. Margulies et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2016)

Article Medicine, General & Internal

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes

Steven P. Marso et al.

NEW ENGLAND JOURNAL OF MEDICINE (2016)

Article Medicine, General & Internal

Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes

Steven P. Marso et al.

NEW ENGLAND JOURNAL OF MEDICINE (2016)

Article Endocrinology & Metabolism

SGLT-2 INHIBITOR THERAPY ADDED TO GLP-1 AGONIST THERAPY IN THE MANAGEMENT OF T2DM

Rachel M. Saroka et al.

ENDOCRINE PRACTICE (2015)