Key result
GLP-1 RAs linked to ~13% lower risk of limb events vs DPP-4 inhibitors in MALE.
Why the study?
Do GLP-1 RAs reduce the risk of lower limb amputation and vascular intervention in patients with type 2 diabetes and a history of major adverse limb events compared to DPP-4 inhibitors?
Cohort (n=12,414)
Do GLP-1 RAs reduce the risk of lower limb amputation and vascular intervention in patients with type 2 diabetes and a history of major adverse limb events compared to DPP-4 inhibitors?
Hazard Ratio: 0.87 (95% CI 0.78–0.96)
In patients with type 2 diabetes and prior major adverse limb events, GLP-1 RAs were associated with a lower risk of subsequent limb events compared to DPP-4 inhibitors.
Background Major adverse limb events (MALE), which include revascularization, chronic limb ischemia, and amputation, are associated with an increased risk of further amputation and subsequent MALE. However, data comparing the effectiveness of different glucose-lowering therapies on clinical outcomes in patients with type 2 diabetes and a history of MALE is limited. This study aims to investigate the potential benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in reducing the risk of limb events in patients who have previously experienced MALE. Methods A total of 12,414 patients with type 2 diabetes and a history of MALE were identified from Taiwan's National Health Insurance Research Database. Among these patients, 944 were prescribed GLP-1 RAs, while 11,470 were prescribed dipeptidyl peptidase-4 (DPP-4) inhibitors. To account for potential confounding factors, propensity score matching was utilized. The primary outcomes were the composite of lower limb amputation and vascular intervention. Results Patients treated with GLP-1 RAs demonstrated a significantly lower risk of composite outcomes, with a subdistribution hazard ratio of 0.87 (95% confidence interval [CI] 0.78–0.96). They also had a reduced risk of amputation, indicated by a subdistribution hazard ratio of 0.54 (95% CI 0.43–0.67). Conclusion GLP-1 RAs were associated with a decreased risk of adverse limb events in patients with type 2 diabetes who have a history of MALE. These findings support the use of GLP-1 RAs in secondary prevention strategies.
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C J Chen (2025) conducted a cohort in Type 2 diabetes with a history of major adverse limb events (MALE) (n=12,414). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) vs. Dipeptidyl peptidase-4 (DPP-4) inhibitors was evaluated on Composite of lower limb amputation and vascular intervention (HR 0.87, 95% CI 0.78-0.96). GLP-1 RAs were associated with a lower risk of lower limb amputation and vascular intervention compared to DPP-4 inhibitors in patients with type 2 diabetes and prior MALE (HR 0.87; 95% CI 0.78-0.96).
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