SGLT-2 inhibitors reduced major adverse cardiovascular events by HR 0.87 in men and 0.83 in women with type 2 diabetes, showing similar benefits across sexes.
Do SGLT-2 inhibitors and GLP-1 receptor agonists provide comparable cardiovascular and kidney benefits in men and women with and without type 2 diabetes?
SGLT-2 inhibitors and GLP-1 receptor agonists provide comparable cardiovascular and kidney benefits across both sexes, despite women being significantly underrepresented in the underlying cardiovascular outcome trials.
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Abstract Aims The extent to which the cardiovascular benefits of sodium–glucose co‐transporter 2 inhibitors (SGLT‐2is) and glucagon‐like peptide 1 receptor agonists (GLP‐1RAs) differ by sex remains unclear. This systematic meta‐analysis aimed to investigate sex differences in trial representation and the cardiovascular and kidney efficacy of SGLT‐2is and GLP‐1RAs in patients with and without type 2 diabetes (T2D). Materials and Methods Cardiovascular outcome trials (CVOTs) were identified through searches in MEDLINE, Embase, and CENTRAL, and manual search of ClinicalTrials.gov up to August 2025. Sex‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using random‐effects meta‐analysis. Sex‐differential treatment effects were assessed using the ratio of HRs and meta‐regression. Results Across 47 articles from 25 unique CVOTs ( n > 185 000) published between 2015 and 2025, women were less represented (approximately one‐third of trial participants). SGLT‐2is and GLP‐1RAs significantly reduced cardio‐kidney outcomes in both men and women. In individuals with T2D, SGLT‐2is significantly reduced risks of major adverse cardiovascular events (MACE) 0.87 (0.80–0.95) and composite cardiovascular death or hospitalization for heart failure 0.73 (0.64–0.83) in men, with broadly similar results for women and also for both sexes in individuals without T2D. In individuals with T2D, GLP‐1RAs reduced MACE risk in men 0.89 (0.82–0.96) and women 0.83 (0.77–0.91). Pooled ratio of HRs showed no significant sex differences, though some cardiovascular benefits appeared slightly greater in women; formal interactions were not statistically significant. Conclusions SGLT‐2is and GLP‐1RAs provide broadly comparable cardio‐kidney benefits across sexes in patients with and without T2D. The lower representation of women in CVOTs warrants attention.
Zawadka et al. (Thu,) reported a other. SGLT-2 inhibitors reduced major adverse cardiovascular events by HR 0.87 in men and 0.83 in women with type 2 diabetes, showing similar benefits across sexes.