Greater CV Benefits With SGLT2 Inhibitors vs GLP-1 Receptor Agonists Added to Metformin in T2D
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersAims
This study aimed to compare cardiovascular benefits associated with the use of GLP-1RA versus SGLT2i as add-on therapies to metformin among adults with type 2 diabetes (T2D) with and without a history of cardiovascular complications, using real-world data.
Methods
Using data from the IBM® MarketScan® Commercial Claims Databases, metformin users above 18 years with T2D who initiated GLP-1RA or SGLT2i were identified. The study endpoints include MI, stroke, CHF, and a cardiovascular composite of these three outcomes. Cox proportional hazard regression models were used to compare the risks of cardiovascular endpoints while controlling for demographics and clinical characteristics.
Results
We identified 13,006 adults with T2D who initiated a GLP-1RA or SGLT2i as an add-on therapy to metformin and followed for a maximum of 5 years. No difference in the endpoints was observed between users of two drugs who did not have established cardiovascular disease at baseline. However, significantly lower CHF risks (HR: 0.47, 95% CI: 0.28–0.79) and cardiovascular composite (HR: 0.67, 95% CI: 0.47–0.97) were observed in SGLT2i users compared with GLP-1RA users, among individuals with established cardiovascular diseases.
Conclusions
Results suggest greater cardioprotective benefit from SGLT2i compared to GLP-1RA when used for secondary prevention among adults with T2D.
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