Cardiovascular Efficacy of GLP-1 Receptor Agonists by Kidney Function: An Updated Meta-Analysis of Randomized Trials Including the SOUL Trial.
Masashi Hasebe, Chen-Yang Su, Daisuke Yabe et al.
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In 30 seconds
This meta-analysis evaluated the cardiovascular efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in adults with type 2 diabetes or obesity, stratified by estimated glomerular filtration rate (eGFR). The analysis included nine publications from eight trials with 70,822 participants. GLP-1RAs reduced major adverse cardiovascular events (MACE) risk similarly in both eGFR groups, with pooled hazard ratios of 0.83 for both eGFR < 60 and ≥ 60 mL/min/1.73 m².
Key findings
- Pooled HR for MACE in eGFR < 60 mL/min/1.73 m² was 0.83 (95% CI 0.74-0.93; p < 0.001).
- Pooled HR for MACE in eGFR ≥ 60 mL/min/1.73 m² was also 0.83 (95% CI 0.77-0.90; p < 0.001).
- Absolute risk reduction (ARR) was larger in eGFR < 60 mL/min/1.73 m² at 2.6% compared to 1.6% in eGFR ≥ 60 mL/min/1.73 m².
- Number needed to treat (NNT) was 39 for eGFR < 60 and 62 for eGFR ≥ 60 mL/min/1.73 m².
Why it matters
Understanding the cardiovascular benefits of GLP-1RAs in patients with varying kidney function is crucial for optimizing treatment strategies in individuals with type 2 diabetes or obesity, particularly those with reduced eGFR.