Combined sodium-glucose-transporters inhibitors (SGLT2i) and glucagon-like-peptide receptor agonist (GLP1ra) compared with SGLT2i or GLP1ra alone improves survival: a Real-World Registry

Prior clinical trials found diabetic patients, after being treated with SGLT2i (sodium-glucose-transporters inhibitors) and/or GLP1ra (glucagon-like-peptide receptor agonist), had lower rates of cardiovascular (CV) complications. However, there is poor evidence of the additive benefits of combined therapy in the general population. David Garcia Vega presented at a session held at the European Society of Cardiology (ESC) Congress from 30th August to 2nd September 2024, in London, the study sought to determine if the combined therapy reduced the major CV complications or all-cause of death in comparison to  SGLT2i or GLP1ra alone in a health area.

This retrospective study examined patients prescribed SGLT2 inhibitors, GLP-1 receptor agonists, or both between January 2018 and June 2022, with follow-up until October 2022. The primary outcomes were hospitalizations and deaths due to heart failure (HF), coronary artery disease (CAD), cerebrovascular accident (CVA), and all-cause mortality.

Among 15,549 patients (97% with type 2 diabetes), combined therapy significantly reduced the risk of HF (HR: 0.771) and all-cause mortality (HR: 0.255). Kaplan-Meier analysis showed similar risks for CAD and CVA across treatment groups. Multivariate Cox regression linked combined therapy, longer treatment duration, and dyslipidemia to lower HF and mortality, while older age, male sex, CAD, HF, and atrial fibrillation increased these risks.

Compared with SGLT2i or GLP1ra alone, combined therapy SGLT2i + GLP1ra reduces HF risk and all-cause mortality in a real-world population.