The following is a summary of the “Effectiveness and safety of the combination of sodium-glucose transport protein 2 inhibitors and glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies,” published in the March 2024 issue of Cardiology by Ahmad et al.
Recent evidence from randomized controlled trials and real-world studies indicates promising outcomes associated with the combined use of sodium-glucose transport protein 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes mellitus (T2DM). However, a comprehensive assessment of real-world data is essential to inform clinical decision-making. This meta-analysis aims to evaluate the safety and effectiveness of SGLT2is + GLP-1RAs combinations, particularly focusing on their cardioprotective effects and glucose-lowering capabilities within a real-world setting.
A systematic search of electronic databases, including PubMed/MEDLINE, PROQuest, Scopus, CINAHL, and Google Scholar was conducted. Qualitative analyses and meta-analyses were performed using the Joanna Briggs Institute SUMARI software package and Review Manager v5.4.
From an initial database search yielding 1,445 articles, 13 met the inclusion criteria for this study. The meta-analysis revealed that the combination of SGLT2is + GLP-1RAs was associated with significantly lower all-cause mortality compared to individual therapies (odds ratio [95% [CI] 0.49 [0.41, 0.60]; p < 0.00001). Furthermore, simultaneous administration of the combination therapy demonstrated significant reductions in body mass index (BMI), systolic blood pressure (SBP), glycated hemoglobin (HbA1c) levels, and fasting plasma glucose (FPG) levels. However, changes in total cholesterol levels did not reach significance.
Based on real-world evidence, the combination of SGLT2is + GLP-1RAs offers favorable outcomes, including reduced all-cause mortality and improved cardiovascular, renal, and glycemic parameters. These findings advocate for this combination therapy’s early and simultaneous incorporation in managing T2DM to harness potential cardiovascular benefits and renal protection.
Source: cardiab.biomedcentral.com/articles/10.1186/s12933-024-02192-4
