Key result
SGLT2i-first combination therapy shows no difference in composite renal outcomes versus GLP1Ra-first initiation.
Why the study?
Combination therapy with SGLT2is and GLP1Ras is of interest, but the effect of the preceding drug type on renal outcomes was unknown.
Does the preceding drug type (SGLT2i vs GLP1Ra) affect renal outcomes in patients with type 2 diabetes mellitus receiving combination therapy?
Cohort (n=643)
Does the preceding drug type (SGLT2i vs GLP1Ra) affect renal outcomes in patients with type 2 diabetes mellitus receiving combination therapy?
p-value: p=.54
In patients with type 2 diabetes on combination SGLT2i and GLP1Ra therapy, the sequence of drug initiation does not significantly impact renal outcomes.
AIMS: Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice. METHODS: We retrospectively extracted type 2 diabetes mellitus patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. Either progression of the albuminuria status and/or a ≥30% decrease in the eGFR was set as the primary renal composite outcome. The analysis using propensity score with inverse probability weighting was performed for the outcome. RESULTS: = .54). A logistic regression analysis showed that the mean arterial pressure (MAP) at baseline, the logarithmic value of the urine albumin-to-creatinine ratio at baseline, and the change in MAP were independent factors influencing the renal composite outcome. CONCLUSION: With combination therapy of SGLT2i and GLP1Ra, the preceding drug did not affect the renal outcome.
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Kobayashi et al. (2023) conducted a cohort in Type 2 diabetes mellitus (n=643). GLP1Ra-preceding treatment vs. SGLT2i-preceding treatment was evaluated on Progression of the albuminuria status and/or a ≥30% decrease in the eGFR (p=.54). In patients with type 2 diabetes on SGLT2i and GLP1Ra combination therapy, the preceding drug type did not significantly affect the primary renal composite outcome (P=0.54).
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