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Abstract: PO1013

Cardiovascular Outcomes with SGLT-2 Inhibitors vs. GLP-1 Receptor Agonists in Patients with Type 2 Diabetes and CKD: A Systematic Review and Network Meta-Analysis

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Yamada, Takayuki, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Bhalla, Abhinav, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Wakabayashi, Mako, Nihon Ika Daigaku Fuzoku Byoin, Bunkyo-ku, Tokyo, Japan
  • Miyashita, Hirotaka, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Ueyama, Hiroki, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Fujisaki, Tomohiro, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Mikami, Takahisa, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Tamura, Kouichi, Yokohama Shiritsu Daigaku Fuzoku Byoin, Yokohama, Kanagawa, Japan
Background

Type 2 diabetes mellitus (DM) and chronic kidney disease (CKD) increase the risk of cardiovascular disease. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are known to reduce cardiovascular disease. However, no study compared the effect of SGLT-2 inhibitors on cardiovascular diseases with that of GLP-1 RAs in CKD patients.

Methods

We performed a systematic literature search up to March 2020. We selected randomized control trials. First, we performed meta-analysis to compare SGLT-2 inhibitors vs placebo and GLP-1 RA vs placebo. Next, we performed a network meta-analysis to compare SGLT-2 inhibitors with GLP-1 RA indirectly. Risk ratios (RRs) with corresponding 95% confidence interval (CI) were synthesized.

Results

Total thirteen studies were selected. SGLT-2 inhibitors led to a risk reduction in MACE (RR [95% CI]; 0.80 [0.72-0.89], p <0.0001). On the other hand, GLP-1 RAs did not show significant difference with high heterogeneity (0.88 [0.74-1.04], p =0.15, I2=58%) (Figure 1). The network meta-analysis did not show significant difference between SGLT-2 inhibitors and GLP-1 RA (0.90 [0.77-1.08]) (Figure 2).

Conclusion

In patients with type 2 DM and CKD, SGLT-2 inhibitors were associated with decreased risk of MACE, but GLP-1 RA did not. Network meta-analysis did not reveal significant difference between SGLT-2 inhibitors and GLP-1 RA.