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Cardiovasc Diabetol: Effects of DPP-4 Inhibitors, GLP-1 Receptor Agonists, and SGLT-2 Inhibitors on Cardiorenal Outcomes

 Last Update: 2022-05-12
 Source: Internet
 Author: User

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Background: Diabetes has reached alarming levels

In the Cardiovascular Outcomes Trial (CVOTS), Concomitant Use of a Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA) and a Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitor ) had a rather unexpected positive cardio-renal outcome, leading to a shift in diabetes management from mere meticulous glycemic control to concurrently improving CV outcomes

The cardiorenal effects of GLP-1RA and SGLT-2 inhibitors can be summarized as follows: GLP-1RA has a moderate benefit on MACE (major cardiovascular event) and reduces all-cause mortality and hospitalizations for heart failure (HHF) , has strong efficacy in reducing the incidence of macroalbuminuria; SGLT-2 inhibitors significantly reduce HHF and renal outcomes, and moderately reduce cardiovascular or total mortality and MACE

METHODS: Computer searches of PubMed, Embase and Cochrane databases for relevant studies published up to December 10, 2021

RESULTS: A total of 23 trials with a total of 181,143 people were included

Figure 1.

Figure 2 Forest plot of the meta-analysis network for cardiovascular death, total death, heart failure hospitalization, and renal outcomes

Table 1 Composite renal outcomes in patients with CVOTS

Figure 3 "Overview" network meta-analysis comparing the effects of SGLT-2 inhibitors, GLP-1RA, and DPP-4 inhibitors on cardiorenal outcomes

Conclusions: SGLT-2 inhibitors and GLP-1RA are superior to DPP-4 inhibitors in reducing the risk of most cardiorenal outcomes; SGLT-2 inhibitors are superior to GLP-1RA in reducing the risk of HHF and renal events; GLP -1RA reduced the risk of non-fatal stroke only

Source: Giugliano D, Longo M, Signoriello S, et al.
The effect of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors on cardiorenal outcomes: a network meta-analysis of 23 CVOTs.
Cardiovasc Diabetol 2022 Mar 16;21(1) The effect of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors on cardiorenal outcomes: a network meta-analysis of 23 CVOTs.

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