New research indicates that using both sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) may provide extra protection against heart and kidney disease in individuals with diabetes. The findings were published in The Lancet Diabetes & Endocrinology and were presented at the 61st European Renal Association Congress in Stockholm, Sweden in May.
SGLT2is and GLP-1RAs are two classes of drugs that help lower blood glucose and improve cardiovascular outcomes. Using these medicines together may improve blood glucose control, but their combined effects on heart disease and kidney failure are not fully clear.
SGLT2is reduced the risk of major adverse cardiovascular events by 11% and hospitalization for heart failure or cardiovascular death by 23% versus placebo. It also reduced the risk of chronic kidney disease progression by 33% and slowed the annual loss of kidney function by almost 60% when added to GLP-1RAs. No new safety concerns were identified when SGLT2is and GLP-1RAs were used in combination.
Clinical Associate Professor Brendon Neuen, Senior Research Fellow at The George Institute for Global Health and lead author on the paper stated, “It was important to look at the effects of GLP-1 receptor agonists with SGLT2 inhibitors due to their expanding indications. This study represents the largest assessment of clinical outcomes for this combination of medicines.”
Associate Professor Neuen mentioned that both classes of medications work independently of each other. SGLT2 inhibitors have clear protective effects against heart failure and chronic kidney disease, while GLP-1 receptor agonists can reduce the risk of heart attack, stroke, and kidney disease, as demonstrated in the landmark FLOW trial. Our findings support the use of this combination to further improve outcomes in patients with type 2 diabetes who meet guideline recommendations for both therapies.apies.
Diabetes is a known risk factor for cardiovascular and kidney disease, with impaired glucose control causing damage to blood vessels in the heart and kidneys.