Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence
ABSTRACT Introduction Developing a more effective treatment for the global impact of diabetic kidney disease is crucial. This study examined the renoprotective effects of combining glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) with sodium–glucose cotransporter 2 inhibitors (SGLT2i) compared t...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Journal of Diabetes Investigation |
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| Online Access: | https://doi.org/10.1111/jdi.14361 |
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| author | Jian‐Yu Jhu Yu‐Wei Fang Chung‐Yen Huang Hung‐Hsiang Liou Mon‐Ting Chen Ming‐Hsien Tsai |
| author_facet | Jian‐Yu Jhu Yu‐Wei Fang Chung‐Yen Huang Hung‐Hsiang Liou Mon‐Ting Chen Ming‐Hsien Tsai |
| author_sort | Jian‐Yu Jhu |
| collection | DOAJ |
| description | ABSTRACT Introduction Developing a more effective treatment for the global impact of diabetic kidney disease is crucial. This study examined the renoprotective effects of combining glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) with sodium–glucose cotransporter 2 inhibitors (SGLT2i) compared to SGLT2is alone in type 2 diabetes (DM). Materials and Methods This retrospective cohort study used data from the TriNetX Global Collaborative Network. Type 2 DM patients with estimated glomerular filtration rates ≥60 mL/min/1.73 m2 who used GLP‐1 RA or SGLT2i between January 1, 2013, and December 31, 2023. Propensity score matching balanced baseline characteristics, resulting in 71,186 patients in each group (combined GLP‐1 RA and SGLT2i therapy vs SGLT2i alone). Cox regression model was adopted to compare outcomes over a 5‐year period, including major adverse kidney events (MAKE), acute kidney injury (AKI), end‐stage kidney disease (ESKD), and all‐cause mortality. Results After matching, the average age was 57.1 ± 10.8 years for the GLP‐1 RA plus SGLT2i group and 57.2 ± 11.7 years for the SGLT2i‐only group. The GLP‐1 RA plus SGLT2i group had significantly lower risk of MAKE (hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.69–0.77), AKI (HR: 0.82, 95% C0I: 0.77–0.87), ESKD (HR: 0.61, 95% CI: 0.47–0.78), and all‐cause mortality (HR: 0.54, 95% CI: 0.50–0.58) compared to the SGLT2i‐only group. Moreover, subgroup analyses showed consistent benefits across different subgroups. Conclusions Dual therapy with GLP‐1 RA and SGLT2i is supported to enhance renal outcomes and address the growing burden of diabetic kidney disease. |
| format | Article |
| id | doaj-art-3bc59a94c911477c963225f30d35f1ae |
| institution | Kabale University |
| issn | 2040-1116 2040-1124 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj-art-3bc59a94c911477c963225f30d35f1ae2025-02-01T10:02:01ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-02-0116220421410.1111/jdi.14361Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidenceJian‐Yu Jhu0Yu‐Wei Fang1Chung‐Yen Huang2Hung‐Hsiang Liou3Mon‐Ting Chen4Ming‐Hsien Tsai5Division of Endocrinology, Department of Internal Medicine Shin‐Kong Wu Ho‐Su Memorial Hospital Taipei TaiwanDivision of Nephrology, Department of Internal Medicine Shin‐Kong Wu Ho‐Su Memorial Hospital Taipei TaiwanDivision of Endocrinology, Department of Internal Medicine Shin‐Kong Wu Ho‐Su Memorial Hospital Taipei TaiwanDivision of Nephrology, Department of Internal Medicine Hsin‐Jen Hospital New Taipei City TaiwanDepartment of Health Care Management National Taipei University of Nursing and Health Sciences Taipei TaiwanDivision of Nephrology, Department of Internal Medicine Shin‐Kong Wu Ho‐Su Memorial Hospital Taipei TaiwanABSTRACT Introduction Developing a more effective treatment for the global impact of diabetic kidney disease is crucial. This study examined the renoprotective effects of combining glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) with sodium–glucose cotransporter 2 inhibitors (SGLT2i) compared to SGLT2is alone in type 2 diabetes (DM). Materials and Methods This retrospective cohort study used data from the TriNetX Global Collaborative Network. Type 2 DM patients with estimated glomerular filtration rates ≥60 mL/min/1.73 m2 who used GLP‐1 RA or SGLT2i between January 1, 2013, and December 31, 2023. Propensity score matching balanced baseline characteristics, resulting in 71,186 patients in each group (combined GLP‐1 RA and SGLT2i therapy vs SGLT2i alone). Cox regression model was adopted to compare outcomes over a 5‐year period, including major adverse kidney events (MAKE), acute kidney injury (AKI), end‐stage kidney disease (ESKD), and all‐cause mortality. Results After matching, the average age was 57.1 ± 10.8 years for the GLP‐1 RA plus SGLT2i group and 57.2 ± 11.7 years for the SGLT2i‐only group. The GLP‐1 RA plus SGLT2i group had significantly lower risk of MAKE (hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.69–0.77), AKI (HR: 0.82, 95% C0I: 0.77–0.87), ESKD (HR: 0.61, 95% CI: 0.47–0.78), and all‐cause mortality (HR: 0.54, 95% CI: 0.50–0.58) compared to the SGLT2i‐only group. Moreover, subgroup analyses showed consistent benefits across different subgroups. Conclusions Dual therapy with GLP‐1 RA and SGLT2i is supported to enhance renal outcomes and address the growing burden of diabetic kidney disease.https://doi.org/10.1111/jdi.14361Glucagon‐like peptide‐1 receptor agonistsMajor adverse kidney eventsSodium–glucose cotransporter 2 inhibitors |
| spellingShingle | Jian‐Yu Jhu Yu‐Wei Fang Chung‐Yen Huang Hung‐Hsiang Liou Mon‐Ting Chen Ming‐Hsien Tsai Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence Journal of Diabetes Investigation Glucagon‐like peptide‐1 receptor agonists Major adverse kidney events Sodium–glucose cotransporter 2 inhibitors |
| title | Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence |
| title_full | Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence |
| title_fullStr | Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence |
| title_full_unstemmed | Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence |
| title_short | Enhanced renoprotective effects of combined glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter 2 inhibitors in type 2 diabetes mellitus: Real‐world evidence |
| title_sort | enhanced renoprotective effects of combined glucagon like peptide 1 receptor agonists and sodium glucose cotransporter 2 inhibitors in type 2 diabetes mellitus real world evidence |
| topic | Glucagon‐like peptide‐1 receptor agonists Major adverse kidney events Sodium–glucose cotransporter 2 inhibitors |
| url | https://doi.org/10.1111/jdi.14361 |
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