Comparable Cardiorenal Benefits of SGLT2 Inhibitors and GLP-1RAs in Asian and White Populations: An Updated Meta-analysis of Results From Randomized Outcome Trials

Abstract

BACKGROUND Whether the cardiorenal benefits of sodium–glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1RAs) are comparable between White and Asian populations remains unclear. PURPOSE To compare the cardiorenal benefits of SGLT2 inhibitors and GLP-1RAs between White and Asian populations and to compare the cardiorenal benefits between the two agents in Asian patients. DATA SOURCES Electronic databases were searched up to 28 March 2021. STUDY SELECTION We included the cardiovascular (CV) and renal outcome trials of SGLT2 inhibitors and GLP-1RAs where investigators reported major adverse CV events (MACE), CV death/hospitali-zation for heart failure (HHF), or composite renal outcomes with stratification by race. DATA EXTRACTION We extracted the hazard ratio of each outcome stratified by race (Asian vs. White populations). DATA SYNTHESIS In 10 SGLT2 inhibitor trials, there was no significant difference between Asian and White populations for MACE (P = 0.55), CV death/HHF (P = 0.87), or composite renal outcomes (P = 0.97). In seven GLP-1RA trials, we observed a similar MACE benefit between Asian and White populations (P = 0.10). In our network-meta-analysis we found a comparable benefit for MACE between SGLT2 inhibi-tors and GLP-1RAs in Asian patients. LIMITATIONS The data were from stratified analyses. CONCLUSIONS There appear to be comparable cardiorenal benefits of SGLT2 inhibitors and GLP-1RAs between Asian and White participants enrolled in CV and renal outcome tri-als; the two therapies seem to have similar CV benefits for Asian participants.