June 5, 2026European Heart Journal12 citationsOpen Access
View Full PaperHeart failure with preserved ejection fraction therapy: combining sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists
Key Result
Combination therapy with SGLT2 inhibitors and GLP-1 receptor agonists in patients with HFpEF and obesity offers potential complementary benefits despite limited data on traditional clinical outcomes.
Key Points
- This research explores the benefits and challenges of combining SGLT2 inhibitors and GLP-1 receptor agonists to treat heart failure with preserved ejection fraction (HFpEF).
- Evaluated the synergy between SGLT2 inhibitors and GLP-1 receptor agonists in patients with HFpEF and obesity.
- Discussed practical considerations, barriers, and gaps in existing data related to combination therapy.
- Focused on optimizing dosing and long-term treatment strategies.
- Established that SGLT2 inhibitors significantly reduce HF hospitalization and death among HFpEF patients.
- Emphasized caution when using incretin therapies in recently decompensated HF, advocating for maximally tolerated doses.
- Identified cost and regimen complexity as critical barriers to effective combination therapy.
Structured PICO
P
Population
Individuals with heart failure with preserved ejection fraction (HFpEF) and obesity
I
Intervention
Combination therapy of sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists
Combining SGLT2 inhibitors and GLP-1 receptor agonists in patients with HFpEF and obesity offers potential complementary benefits, though practical barriers and research gaps remain.
Limitations
- Limited data on traditional clinical outcomes
- Cost
- Polypharmacy
- Regimen complexity
- Paucity of data in important subpopulations
Abstract
Potential for complementary bene ts on global treatment priorities Prioritize SGLT2i given established bene ts on HF hospitalization and death Caution with incretin-based therapies in recently decompensated HF Escalate incretin-based therapies to maximally tolerated dose Continue therapy inde nitely to prevent disease relapse or progression Limited data on traditional clinical outcomes Practical considerations for combination therapy Potential barriers and research priorities Cost Polypharmacy Regimen complexity Paucity of data in important subpopulations HFpEF therapy: combining SGLT2i and incretins Practical considerations, potential barriers, and research gaps relating to sodium-glucose co-transporter 2 inhibitor and glucagon-like peptide-1 receptor agonist combination therapy in individuals with heart failure with preserved ejection fraction and obesity.HF, heart failure; SGLT2i, sodium-glucose co-transporter 2 inhibitor
Expert Takes4 quotes
1/4
“Will we see progressive providers prescribing 'ahead' of guidelines? Maybe. A recent JACC editorial suggests that SGLT2is and GLP-1 RAs should be considered standard of care for high-risk individuals, given the clear benefits of each drug via distinct pathways. That said, the majority of patients who could benefit from either (or both) of these therapies are not getting them – highlighting the need for additional data and tools that could influence practice patterns.”