Effectiveness of Various Type 2 Diabetes Agents Differs With Cardiorenal Outcome

Different medications in two new classes of hypoglycemic agents offer different benefits for specific cardiorenal outcomes in patients with type 2 diabetes, suggests a network meta-analysis published online in Medicine.

“Sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have been demonstrated to be able to improve the cardiovascular and renal prognosis in patients with type 2 diabetes,” researchers wrote in the study background. “However, the relative efficacy of various SGLT2 inhibitors and GLP-1 RAs on cardiorenal outcomes is unestablished.”

The network meta-analysis, an update of a previous investigation that did not assess sotagliflozin and ertugliflozin, included 14 cardiovascular or renal outcome trials involving patients with type 2 diabetes.

According to the findings, the following medications showed the greatest effects:

• for lowering major adverse cardiovascular events: sotagliflozin, subcutaneous semaglutide, and albiglutide;
• for lowering hospitalization for heart failure: sotagliflozin, canagliflozin, and empagliflozin;
• for lowering kidney function progression: dapagliflozin and empagliflozin;
• for lowering cardiovascular death: empagliflozin and oral semaglutide;
• for lowering myocardial infarction: sotagliflozin and albiglutide;
• for lowering stroke: sotagliflozin and subcutaneous semaglutide; and
• for lowering all-cause death: oral semaglutide and empagliflozin.

“In conclusion, this updated network meta-analysis reproduced the findings in the first network meta-analysis, and moreover revealed that sotagliflozin was one of the most effective drugs as for lowering myocardial infarction, stroke, major adverse cardiovascular events, and hospitalization for heart failure, whereas ertugliflozin was not,” researchers concluded. “These findings will provide…evidence regarding the usage of specific SGLT2 inhibitors and GLP-1 RAs in type 2 diabetes patients for prevention of specific cardiorenal endpoints.”

Reference:
Duan XY, Liu SY, Yin DG. Comparative efficacy of 5 sodium glucose cotransporter 2 inhibitor and 7 glucagon-like peptide 1 receptor agonists interventions on cardiorenal outcomes in type 2 diabetes patients: a network meta-analysis based on cardiovascular or renal outcome trials. Medicine (Baltimore). 2021;100(30):e26431. doi:10.1097/MD.0000000000026431