Using a combination of sodium-glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) is likely to offer additional protection against heart and kidney disease in patients with diabetes, according to a study.
SGLT2is, also called
gliflozins, are a class of drugs that lower blood glucose by increasing its
excretion in the urine, while GLP-1RAs, such as Ozempic, work by enhancing
insulin release and sensitivity.
Impaired glucose control
in patients with diabetes is known to cause damage to blood vessels in the
heart and kidneys.
According to lead author
Brendon Neuen, Clinical Associate Professor from The George Institute for
Global Health, "the rapidly expanding indications for the use of GLP-1
receptor agonists, makes it important to look at their effects with SGLT2
inhibitors".
The new findings,
published in The Lancet Diabetes & Endocrinology, are based on a
meta-analysis of 12 large-scale, placebo-controlled trials of SGLT2is involving
73,238 patients with diabetes, 3,065 of whom were already receiving GLP1-RAs.
The results showed that
SGLT2is reduced the risk of heart attack, stroke, or cardiovascular death by 11
per cent, independent of GLP1-RAs.
It also decreased
hospitalisation for heart failure or cardiovascular death by 23 per cent versus
placebo, even when added to GLP1-RAs.
Further, the drug
SGLT2is also reduced the risk of chronic kidney disease progression by 33 per
cent when added to GLP1-RAs and slowed the annual loss of kidney function by
almost 60 per cent when added to GLP-1RAs.
Importantly, no new
safety concerns were identified when SGLT2is and GLP-1RAs were used in
combination, the team said.
Both classes of
medicines work independently of each other -- SGLT2 inhibitors against heart
failure and chronic kidney disease; GLP-1 receptor agonists against heart
attack, stroke, and also kidney disease, Neuen said.
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