New study reveals that using sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) together can offer extra protection against heart and kidney diseases in diabetic patients.
Research suggests that combining SGLT2is and GLP1-RAs can provide added defense against heart and kidney issues in diabetes patients. This information was recently published in The Lancet Diabetes & Endocrinology and presented at the 61st European Renal Association Congress in Stockholm, Sweden.
SGLT2is, also known as gliflozins, are medications that lower blood glucose levels by increasing its excretion in urine, while GLP-1RAs, like Ozempic, enhance insulin release and sensitivity. Both drug classes have shown to improve heart health outcomes. Previous studies have suggested that using these medications together can enhance blood sugar control, but their combined effects on heart and kidney diseases have been uncertain.
Researchers from the SGLT2 Inhibitor Meta-analysis Cardio-Renal Trialists’ Consortium (SMART-C) analyzed data from 12 large-scale trials involving 73,238 diabetic patients who were taking SGLT2is, including 3,065 patients who were also on GLP1-RAs. The analysis revealed that the benefits of SGLT2is were seen even when combined with GLP1-RAs.
When added to GLP1-RAs, SGLT2is reduced the risk of major adverse cardiovascular events by 11% and the risk of hospitalization for heart failure or cardiovascular death by 23% compared to a placebo. Additionally, the combination lowered the risk of kidney disease progression by 33% and slowed down kidney function decline by almost 60% when added to GLP1-RAs. No new safety concerns were identified when using SGLT2is and GLP1-RAs together.
Clinical Associate Professor Brendon Neuen, Senior Research Fellow at The George Institute for Global Health and lead author of the study, commented, “Given the increasing use of GLP-1 receptor agonists, it was crucial to investigate their effects in combination with SGLT2 inhibitors. This research provides the most extensive evaluation of the clinical outcomes of this medication combination.”
Prof. Neuen added, “Both drug classes have their own protective effects: SGLT2 inhibitors help prevent heart failure and kidney disease progression, while GLP-1 receptor agonists can reduce the risk of heart attacks, strokes, and kidney disease, as demonstrated in the significant FLOW trial. Our findings support using this combination to enhance outcomes in type 2 diabetes patients who qualify for both treatments.”
Diabetes is a known risk factor for heart and kidney diseases because poor glucose control can harm blood vessels in these organs. Many diabetes patients suffer from cardiovascular disease or chronic kidney disease, with the prevalence increasing after a diabetes diagnosis.
A/Prof Brendon Neuen and Prof Hiddo Heerspink from The George Institute for Global Health are leading SMART-C.
