Cardiovascular and renal effects of the combination therapy of a GLP-1 receptor  agonist and an SGLT2 inhibitor in observational real-life studies.

Scheen, André

doi:10.1016/j.diabet.2024.101594

Article (Scientific journals)

Cardiovascular and renal effects of the combination therapy of a GLP-1 receptor agonist and an SGLT2 inhibitor in observational real-life studies.

Scheen, André

2025 • In Diabetes and Metabolism, 51 (1), p. 101594

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/340414

DOI
10.1016/j.diabet.2024.101594

PubMed
39608670

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Keywords :

Cardiovascular outcome; Combined therapy; GLP-1 receptor agonist; Renal outcome; SGLT2 inhibitor

Abstract :

[en] BACKGROUND: Combining a glucagon-like peptide-1 receptor agonist (GLP-1RA) and an sodium-glucose cotransporter 2 inhibitor (SGLT2i) improved cardiovascular (and renal) prognosis compared to either monotherapy in several post-hoc exploratory analyses of randomized controlled trials (RCTs) versus placebo carried out in patients with type 2 diabetes (T2DM) and high cardiovascular/renal risk. The aim of the present work is to verify if such a benefit of the combined therapy is also present in real-life clinical practice. METHODS: An extended search of the literature was performed to select observational retrospective studies that compared cardiovascular and/or renal outcomes in patients with T2DM treated with a GLP-1RA/SGLT2i combination versus patients treated with either GLP-1RA monotherapy or SGLT2i monotherapy, in addition to standard of care therapy. RESULTS: Nine observational studies showed that a GLP-1RA/SGLT2i combination is associated with a greater reduction in major adverse cardiovascular events (MACEs), hospitalization for heart failure and all-cause-mortality when compared to either GLP-1RA alone or SGLT2i alone, without obvious differences between the two monotherapies, including regarding heart failure. Results were obtained in different populations, including patients with atherosclerotic cardiovascular disease and/or heart failure. Only three observational studies gave information on renal outcomes, with a greater benefit when the GLP-1RA/SGLT2i combination was compared with GLP-1RA alone or SGLT2i alone. CONCLUSION: In real-life conditions, the GLP-1RA/SGLT2i combination reduced cardiovascular and renal outcomes compared with both GLP-1RA monotherapy and SGLT2i monotherapy. Overall, observational studies confirm the results reported in post-hoc exploratory analyses of RCTs versus placebo.

Disciplines :

Endocrinology, metabolism & nutrition
Cardiovascular & respiratory systems

Author, co-author :

Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques

Language :

English

Title :

Cardiovascular and renal effects of the combination therapy of a GLP-1 receptor agonist and an SGLT2 inhibitor in observational real-life studies.

Publication date :

2025

Journal title :

Diabetes and Metabolism

ISSN :

1262-3636

eISSN :

1878-1780

Publisher :

Elsevier Masson, Paris, Fr

Volume :

Issue :

Pages :

101594

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 27 January 2026

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