Key result
GLP-1RAs cut MACE ~17% regardless of baseline kidney function, yielding greater absolute benefit in CKD.
Why the study?
To evaluate the cardiovascular efficacy and absolute benefit of GLP-1 receptor agonists stratified by baseline estimated glomerular filtration rate.
Do glucagon-like peptide-1 receptor agonists reduce major adverse cardiovascular events consistently across baseline kidney function strata (eGFR <60 vs ≥60 mL/min/1.73 m²) in adults with type 2 diabetes or overweight/obesity?
Meta-Analysis (n=70,822)
Placebo-controlled
Yes
Do glucagon-like peptide-1 receptor agonists reduce major adverse cardiovascular events consistently across baseline kidney function strata (eGFR <60 vs ≥60 mL/min/1.73 m²) in adults with type 2 diabetes or overweight/obesity?
Hazard Ratio: 0.83 (95% CI 0.74–0.93)
Absolute Event Rate: 13.2% vs 15.3%
Absolute Risk Reduction: 2.6%
Number Needed to Treat: 39
p-value: p=<0.001
GLP-1 receptor agonists provide an identical 17% relative reduction in major adverse cardiovascular events regardless of whether baseline eGFR is <60 or ≥60 mL/min/1.73 m², resulting in a greater estimated absolute risk reduction (2.6% vs 1.6%) and lower number needed to treat (39 vs 62) in patients with reduced kidney function due to their higher baseline cardiovascular risk.
GLP-1RAs yield larger absolute MACE reduction in eGFR <60 (NNT 39 vs 62); confirms uniform relative efficacy across kidney function.
Aims To evaluate the cardiovascular efficacy and absolute benefit of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) by baseline estimated glomerular filtration rate (eGFR). Materials and Methods PubMed and EMBASE were searched to 29 April 2026 for randomized placebo‐controlled trials of GLP‐1RAs in adults with type 2 diabetes or overweight/obesity that reported eGFR‐stratified major adverse cardiovascular events (MACE). Hazard ratios (HRs) were extracted for eGFR < 60 and ≥ 60 mL/min/1.73 m 2 . Random‐effects meta‐analyses estimated pooled HRs within each eGFR stratum and the pooled ratio of HRs (RHR) comparing eGFR < 60 versus ≥ 60 mL/min/1.73 m 2 . Exploratory absolute risk reduction (ARR) and number needed to treat (NNT) were derived from placebo‐group MACE risk and the corresponding pooled HR. Results Nine publications from eight trials were included, comprising 70 822 participants; 70 534 had eGFR‐stratified MACE data. GLP‐1RAs similarly reduced MACE risk among participants with eGFR ≥ 60 and < 60 mL/min/1.73 m 2 , with pooled HRs of 0.83 (95% CI 0.77–0.90; p < 0.001; I 2 = 35.6%) and 0.83 (95% CI 0.74–0.93; p < 0.001; I 2 = 40.9%), respectively. The pooled RHR showed no evidence of effect modification (1.02, 95% CI 0.85–1.21; p = 0.84). ARR was larger with eGFR < 60 than ≥ 60 mL/min/1.73 m 2 (2.6% vs. 1.6%), corresponding to NNTs of 39 (95% CI 26–91) versus 62 (95% CI 46–101). Conclusions GLP‐1RAs reduced MACE risk similarly across eGFR strata, while lower eGFR was associated with a larger estimated absolute cardiovascular benefit. These findings support GLP‐1RA therapy in individuals with reduced kidney function.
No takes yet. Share an insight, caveat, or question.
Hasebe et al. (2026) conducted a meta-analysis in Type 2 diabetes or overweight/obesity stratified by baseline kidney function (eGFR <60 vs >=60 mL/min/1.73 m2) (n=70,822). Glucagon-like peptide-1 receptor agonists (GLP-1RAs: liraglutide, subcutaneous or oral semaglutide, exenatide, albiglutide) vs. Placebo was evaluated on Major adverse cardiovascular events (MACE: composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in participants with baseline eGFR <60 mL/min/1.73 m2 (HR 0.83, 95% CI 0.74-0.93, p=<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: