Similar incidence of stroke with SGLT2 inhibitors and GLP-1 receptor agonists in real-world cohort studies among patients with type 2 diabetes

Scheen, André

doi:10.1016/j.deman.2023.100179

Article (Scientific journals)

Similar incidence of stroke with SGLT2 inhibitors and GLP-1 receptor agonists in real-world cohort studies among patients with type 2 diabetes

Scheen, André

2024 • In Diabetes Epidemiology and Management, 13, p. 100179

Peer reviewed

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https://hdl.handle.net/2268/318536

DOI
10.1016/j.deman.2023.100179

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Keywords :

GLP-1 receptor agonist; Observational cohort study; Meta-analysis; Real-world evidence; SGLT2 inhibitor; Stroke

Abstract :

[en] Background Stroke represents a major burden in patients with type 2 diabetes. Yet, this cerebrovascular complication has been less well studied than coronary artery disease and heart failure. Some cardiovascular outcome data suggested that sodium-glucose cotransporter 2 inhibitors (SGLT2is) exert a less pronounced protection against stroke compared with glucagon peptide-1 receptor agonists (GLP-1RAs) despite similar efficacy regarding major cardiovascular events (MACE-3 points). However, this conclusion was derived from indirect comparisons of placebo- controlled trials (RCTs). Methods The present comprehensive review analyses the effects of SGLT2is versus GLP-1RAs on nonfatal and fatal/nonfatal strokes in real-life studies carried out worldwide. Results A large majority of retrospective observational cohort studies (19 out of 21) failed to find any significant difference in the risk of stroke between the two pharmacological classes, independently of the presence of established cardiovascular disease. Available, yet limited, findings suggested that SGLT2is could be more efficacious against haemorrhagic than ischaemic strokes, in patients at risk for atrial fibrillation or with chronic kidney disease. Conclusion In contrast to what was reported in RCTs, most observational studies showed similar incidence of stroke in SGLT2i users versus GLP-1RA users. Because both indirect comparisons of RCTs and retrospective cohort studies have limitations, a head-to-head RCT comparing the effects on stroke of an SGLT2i versus a GLP-1RA is needed to draw any definite conclusion.

Disciplines :

Endocrinology, metabolism & nutrition
Pharmacy, pharmacology & toxicology
Cardiovascular & respiratory systems

Author, co-author :

Scheen, André ; Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques

Language :

English

Title :

Similar incidence of stroke with SGLT2 inhibitors and GLP-1 receptor agonists in real-world cohort studies among patients with type 2 diabetes

Publication date :

2024

Journal title :

Diabetes Epidemiology and Management

ISSN :

2666-9706

Volume :

Pages :

100179

Peer reviewed :

Peer reviewed

Additional URL :

https://www.sciencedirect.com/science/article/pii/S2666970623000586

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since 23 May 2024

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