According to American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus, SGLT-2 inhibitors should be preferred over GLP-1 receptor agonists (GLP-1 RAs) in patients with a high risk of established atherosclerotic cardiovascular disease (ACVD), heart failure (HF), or chronic kidney disease (CKD) if HF or CKD predominates.1
However, this view has recently been challenged since both classes may offer benefits to reduce adverse cardiovascular (CV) events, but SGLT-2 inhibitors are preferred for patients with HF.2
This view also sustains that renal function is improved by both classes, but low eGFR is an important determinant of eligibility, and issues of safety, cost, and individual preferences of clinicians and patients will have a strong impact when choosing between them.2
How was this study conducted?
This observational, retrospective study compared CV outcomes of patients who received SGLT-2 inhibitors or a GLP-1 RA in real-world settings.
Registry data was used from the Veneto region in northeast Italy.
Between 2014 and 2018, 7192 patients initiated a SGLT-2 inhibitor and 5804 initiated a GLP-1 RA.
Propensity score matching was used to create two cohorts with identical baseline characteristics (4298 patients in each).
Outcomes were collected on laboratory parameters, CV outcomes and adverse events.
Buse JB, Wexler DJ, Tsapas A, et al. 2019 update to: management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2020 Feb;63(2):221-8.
This is a highlights summary of an oral session given at the EASD 2020 Virtual Meeting and presented by:
Gian Paolo Fadini, MD
Dept. of Medicine, University of Padova, Italy
The presenting authors of the original session had no part in the creation of this conference highlights summary.
The content is produced by Infomedica. The summary text was drafted by Patrick Moore, PhD, and reviewed by Marco Gallo, MD, an independent external expert, and approved by Florian Toti, MD, the scientific editor of the program.