SGLT2 inhibitors superior to GLP-1 receptor agonists for lowering HF hospitalizations: Study

Both sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown cardiovascular benefits in placebo-controlled trials of patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD).

A group of researchers from the U.S.A conducted a study to evaluate whether SGLT2 inhibitors and GLP-1 RAs are associated with differential cardiovascular benefits among T2D patients with and without CVD.

Primary outcomes were myocardial infarction (MI) or stroke hospitalization and hospitalization for heart failure (HHF). Pooled hazard ratios (HRs) and rate differences (RDs) per 1000 person-years were estimated, with 95% CIs, controlling for 138 preexposure covariates.

The results of the study are as follows:

· The initiation of SGLT2 inhibitor versus GLP-1 RA therapy was associated with a slightly lower risk for MI or stroke in patients with CVD but the similar risk in those without CVD.

· The initiation of SGLT2 inhibitor versus GLP-1 RA therapy was associated with reductions in HHF risk regardless of baseline CVD in patients with CVD and in those without CVD

Thus, the researchers concluded that the use of SGLT2 inhibitors versus GLP-1 RAs was associated with consistent reductions in HHF risk among T2D patients with and without CVD, although the absolute benefit was greater in patients with CVD. There were no large differences in risk for MI or stroke among T2D patients with and without CVD.

Reference:

A study titled, "Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients with Diabetes Across Categories of Cardiovascular Disease" by Patorno E et. al published in the Annals of Internal Medicine.

https://doi.org/10.7326/M21-0893