SGLT2is vs. GLP1RAs Reduce Cardiovascular and All-Cause Mortality

Lin et al. recently did a network meta-analysis based on cardiovascular (CV) outcome trials (CVOTs) of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and those of glucagon-like peptide-1 receptor agonists (GLP1RAs). Due to the absence of CVOTs directly comparing SGLT2is with GLP1RAs, Lin et al.'s network meta-analysis identified the indirect evidence that SGLT2is vs. GLP1RAs reduced hospitalization for heart failure (HHF) but did not reduce CV death and all-cause mortality (ACM) in patients with type 2 diabetes (T2D). We did another meta-analysis incorporating those CV outcome cohort studies directly comparing SGLT2is with GLP1RAs, and identified that SGLT2is vs. GLP1RAs were significantly associated with the lower risks of not only HHF but also CV death and ACM. These findings may suggest that SGLT2is should be considered over GLP1RAs in terms of preventing CV and all-cause death and HHF in T2D patients.

Automated summary

Lin et al. conducted a network meta-analysis comparing SGLT2is and GLP1RAs in CV outcome trials, finding that SGLT2is were more effective in reducing HHF risk but not as effective in reducing CV death and ACM. Another meta-analysis directly comparing SGLT2is with GLP1RAs showed that SGLT2is were associated with lower risks of HHF, CV death, and ACM, suggesting that SGLT2is may be preferred over GLP1RAs in preventing CV and all-cause death in patients with T2D.