Table 1.
Characteristics of studies included in the meta-analysis
| First author, year (ref.) | Study Design | Follow-up, months | Population | Age, years (Int/Ctrl) | No. of patients (Int/Ctrl) | Intervention | Comparator | Study Primary Outcome | Outcome included in Meta-Analysis |
|---|---|---|---|---|---|---|---|---|---|
| Badjatiya [22] | RCT, double blind (post-hoc analysis) | 38.4 | T2D with PAD | 61.9 | 1400/1400 | Exenatide | Placebo | The first occurrence of death from cardiovascular causes, all-cause mortality | Major limb events, LEA, gangrene, revascularization, MACE, all-cause mortality |
| Hsiao [24] | Retrospective cohort (IPTW) | 9.6/18a | T2D with LEAD | 59.0 ± 12.6/58.8 ± 12.1 | 109/361 | GLP-1 RAs | SGLT-2 inhibitors | EVT for LEAD, newly developed LEAD-related foot ulcers, or non-traumatic LLA | Major limb events |
| Rodionov [25] | Retrospective cohort (IPW) | 18.2/13.4a | T2D with PAD | 67.9 ± 9.0/68.0 ± 9.1 | 2074/6032 | GLP-1 RAs | SGLT-2 inhibitors | Minor and major LEA, HHF | LEA |
| Lin [26] | Retrospective cohort (PSM) | 23.5/23.2b | T2D with LEAD | 56.4 ± 13.2/56.9 ± 13.0 | 1644/6759 | GLP-1 RAs | SGLT-2 inhibitors | Newly diagnosed CLI, PTA or peripheral bypass surgery for PAD, and non-traumatic amputation | Major limb events |
| Bonaca [23] | RCT, double blind | 12 | T2D with PAD | 396/396 | Semaglutide | Placebo | Ratio to baseline of the maximum walking distance | Major limb events, LEA, all-cause mortality, revascularization | |
| Caruso [27] | Retrospective cohort (PSM) | 30.1c | T2D with PAD or foot ulcers | 60.8 ± 10.6/61.5 ± 10.8 | 167/167 | Semaglutide | Other GLTs (no GLP1/DPP4) | PTA and/or CLI | Major limb events, LEA |
| Go [28] | Retrospective cohort (PSM) | 12 | T2D with PAD | 62.4 ± 12.7e | 41,627/41,627 | GLP-1 RAs | No GLP1-RAs | Major amputation or acute limb ischemia requiring intervention, MACE and 1-year mortality | Major limb events, MACE |
| Hong [29] | Retrospective cohort (PSM) | 36 | T2D and PAD | 66.5 ± 10.1/66.6 ± 10.6 | 77,393/77,393 | GLP-1 RAs | SGLT-2 inhibitors | Major LEA (above ankle) | Major LEA, any LEA, all-cause mortality |
| 36 | T2D and PAD | 67.4 ± 10.3/67.5 ± 10.6 | 39,907/39,907 | GLP-1 Ras | DPP4 inhibitors | Major LEA (above ankle) | Major LEA, any LEA, all-cause mortality | ||
| Lewis [30] | Retrospective cohort (PSM) | 12 | T2D and DFU | 56.7 ± 11.4e | 6329/6329 | Semaglutide | No Semaglutide | Wound healing complications and amputation | Amputation |
| Wu [31] | Retrospective cohort (PSM) | 12 | T2D and PAD | 63.6 ± 11.3/63.3 ± 12.6 | 4023/4023 | Tirzepatide | No Tirzepatide | Amputation and repair | Major limb events |
| Hsiao [33] | Retrospective cohort (IPTW) | 49.2 | T2D with MALE | 68.9 ± 11.6/70.8 ± 11.9 | 10,731/17,072 | GLP-1 Ras | DPP4 inhibitors | Lower limb revascularization or nontraumatic major or minor amputation | Major limb events, MACE, all-cause mortality |
| Yahyavi [32] | Retrospective cohort (PSM) | 24.8d | T2D with CLTI | 65.4 ± 10.5/65.4 ± 11.5 | 15,743/15,743 | GLP-1 RAs | No GLP-1 RA | Major lower limb amputation (below or above-the-knee amputation) | Major amputation, all cause-mortality |
CLI critical limb ischemia, CLTI critical limb-threatening ischemia, DFU diabetic foot ulcers, EVT endovascular therapy, GLTs glucose-lowering therapies, HHF hospitalization heart failure, IPW inverse probability weighting, IPTW inverse probability of treatment weighting, LEA lower extremity amputation, LEAD lower extremity arterial disease, LLA lower limb amputation, MACE major adverse cardiovascular events, MALE major adverse limb events, OR observational retrospective, PAD Peripheral Artery Disease, PAT percutaneous transluminal angioplasty, PSM propensity score matching, RCT randomized controlled trial, T2D type 2 diabetes
aMedian follow-up intervention/control groups
bMean follow-up intervention/control groups
cMedian follow-up
dMean follow-up
e overall population