Cardiovascular, kidney, and safety outcomes with GLP-1 receptor agonists alone and in combination with SGLT2 inhibitors in type 2 diabetes: a systematic review and meta-analysis
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Background GLP-1 (glucagon-like peptide-1) receptor agonists and SGLT2 (sodium-glucose cotransporter 2) inhibitors both improve cardiovascular and kidney outcomes in people with type 2 diabetes. We conducted a systematic review and meta-analysis to assess the effects of GLP-1 receptor agonists on clinical outcomes with and without SGLT2 inhibitors. Methods We searched MEDLINE and Embase databases from inception until July 12, 2024, for randomized, double-blind, placebo-controlled outcome trials of GLP-1 receptor agonists in type 2 diabetes that reported treatment effects by baseline use of SGLT2 inhibitors, with findings supplemented by unpublished data. We estimated treatment effects by baseline SGLT2 inhibitor use using inverse variance-weighted meta-analysis. The main cardiovascular outcomes were major adverse cardiovascular events (nonfatal myocardial infarction, stroke, or cardiovascular death) and hospitalization for heart failure. Kidney outcomes included a composite of ≥50% reduction in estimated glomerular filtration rate, kidney failure or death caused by kidney failure, and annualized rate of decline in estimated glomerular filtration rate (estimated glomerular filtration rate slope). Serious adverse events and severe hypoglycemia were also evaluated. This meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024565765). Results We identified 3 trials with 1743 of 17 072 (10.2%) participants with type 2 diabete…
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GLP-1 RAs reduce risks of cardiovascular disease events and slow progression of CKD.
“GLP-1 RAs are suggested for cardiovascular risk reduction if such risk is a predominant problem, as they reduce risks of CVD events and slow progression of CKD (109,118-122).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [121]
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Combining GLP-1 Receptor Agonists and SGLT2 Inhibitors for Cardiorenal Prevention
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GLP-1 Receptor Agonists and Cardiovascular and Kidney Outcomes by Body Mass Index in Type 2 Diabetes
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Antidiabetic combination therapy and cardiovascular outcomes: An evidence-based approach
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Evaluation and Management of Obesity in Chronic Kidney Disease
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Cardiovascular-Kidney-Metabolic Health
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Kidney and Survival Benefits of Semaglutide in Diabetes With Chronic Kidney Disease
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Advances in Cardiorenal Medicine: The Year 2024 in Review
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A Framework for Risk-Based Implementation of Combination Therapy in CKD
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- Authors
- Neuen, B. L., Fletcher, R. A., Heath, L., Perkovic, A., Vaduganathan, M., Badve, S. V., Tuttle, K. R., Pratley, R., Gerstein, H. C., Perkovic, V., & Heerspink, H. J. L.
- Affiliations
- Royal North Shore Hospital (AU)
- UNSW Sydney (AU)
- Brigham and Women's Hospital (US)
- University of Washington (US)
- AdventHealth Orlando (US)
- Population Health Research Institute (CA)
- University Medical Center Groningen (NL)
- Corresponding author
- Neuen, Brendon L.
- ORCID
- Venue
- Circulation
- Published
- 2024-11-26
- Volume
- 150
- Issue
- 22
- Pages
- 1781-1790
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W4402066452
- Cited by
- 168
- References
- 31
- Citations by year
- 2026: 88 · 2025: 75 · 2024: 5
- FWCI
- 9.86
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- other-oa
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- GLP-1 receptor agonists, SGLT2 inhibitors, type 2 diabetes, major adverse cardiovascular events, heart failure hospitalization, renal outcomes, estimated glomerular filtration rate decline, renal failure, serious adverse events, hypoglycemia, combination therapy, drug safety, cardiovascular safety, renal safety, drug-drug interactions, drug repurposing
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Sodium-Glucose Transporter 2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Glomerular Filtration Rate, Humans, Hypoglycemic Agents, Kidney, Randomized Controlled Trials as Topic, Treatment Outcome
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