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[Innovative therapeutic drug combination for type 2 diabetes at cardiorenal risk]

André J Scheen1, Nicolas Paquot1

  • 1Service de diabétologie, nutrition et maladies métaboliques, Département de médecine, Centre hospitalier universitaire de Liège, 4000 Liège, Belgique.

Revue Medicale Suisse
|September 2, 2024
PubMed

Insights

Combining glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) shows improved cardiorenal outcomes in type 2 diabetes patients. Further confirmation is pending in a large prospective trial.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Context:

  • Type 2 diabetes poses significant cardiorenal risks.
  • GLP-1 receptor agonists (GLP-1RA) and SGLT2 inhibitors (SGLT2i) offer cardiorenal protection.
  • Pleiotropic effects of these drug classes are key to their benefits.

Purpose:

  • To discuss the clinical efficacy of combined GLP-1RA and SGLT2i therapy.
  • To review evidence from post hoc analyses and real-world observational studies.
  • To highlight the potential of combination therapy for at-risk type 2 diabetes patients.

Summary:

  • Combined GLP-1RA and SGLT2i therapy demonstrates superior cardiorenal benefits compared to monotherapy.
  • Evidence stems from subgroup analyses of cardiovascular outcome trials and retrospective cohort studies.
  • An ongoing large prospective trial (PRECIDENTD) aims to confirm these findings.

Impact:

  • Combination therapy may represent a significant advancement in managing cardiorenal risk in type 2 diabetes.
  • The cost-effectiveness and clinical adoption of this combination require careful consideration.
  • Addressing the underuse of individual drug classes is crucial for maximizing patient benefit.

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