GLP-1 Receptor Agonist Therapy With and Without SGLT2 Inhibitors in Patients With Type 2 Diabetes
Authors' conclusion
In patients with T2D and cardiovascular disease, GLP-1 RAs reduced cardiovascular events independently of SGLT2 inhibitor use.
Study context
- Population
- T2DM with CVD (Harmony Outcomes) or with CVD or renal disease (AMPLITUDE-O), by SGLT2 inhibitor use575 (6.1%) on SGLT2 inhibitors
- Participants
- 9,462 participants
- Comparison
- GLP-1 RAs vs placebo, with and without SGLT2 inhibitors
- Outcome
- MACE:
- CV death
- MI
- Stroke
Methodological detailsHarmony Outcomes and AMPLITUDE-O, subgroup analysis by background SGLT2 inhibitor use
- Harmony Outcomes and AMPLITUDE-O
- Subgroup analysis by background SGLT2 inhibitor use
Pooled result
As reported in the abstract
MACE by SGLT2 inhibitor use
GLP-1 RA vs PlaceboHazard ratio (95% CI)
Without SGLT2 inhibitors; meta-analysis
0.77(0.68–0.87)
With SGLT2 inhibitors; meta-analysis
0.78(0.49–1.24)
- Albiglutide effect on MACE consistent with or without SGLT2 inhibitors (Harmony Outcomes)
- P for interaction = 0.70
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| HF hospitalization by SGLT2 inhibitor use (meta-analysis)GLP-1 RAvs PlaceboWithout SGLT2 inhibitors | 0.72 (0.55–0.92) | |
| HF hospitalization by SGLT2 inhibitor use (meta-analysis)GLP-1 RAvs PlaceboWith SGLT2 inhibitors | 0.34 (0.12–0.96) | |
| 0.10.31310Hazard ratio (log scale) |
- HF hospitalization by SGLT2 inhibitor use (meta-analysis): interaction P = 0.18
Secondary outcomes (Harmony Outcomes)
- Albiglutide effect on secondary outcomes not modified by SGLT2 inhibitors
Original publication
GLP-1 Receptor Agonist Therapy With and Without SGLT2 Inhibitors in Patients With Type 2 Diabetes. J Am Coll Cardiol. Published 8 August 2023. doi:10.
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