Table 1.
GLP-1RA | SGLT2 inhibitor | |||||
---|---|---|---|---|---|---|
Once-daily | Once-weekly | |||||
ELIXA (lixisenatide) | LEADER (liraglutide) | SUSTAIN-6 (semaglutide) | EXSCEL (exenatide) | EMPA-REG OUTCOME (empagliflozin) | CANVASa (canagliflozin) | |
Patient number | 6058 | 9340 | 3297 | 14,752 | 7020 | 10,142 |
Median follow-up duration (years) | 2.1 | 3.8 | 2.1 | 3.2 | 3.1 | 2.4 |
Key eligibility | T2D with recent ACS | T2D with high CV risk | T2D with high CV risk | T2D with high CV risk | T2D with previous CV disease | T2D with high CV risk |
Prior CV disease (%) | 100 | 81 | 60 | 73 | 99 | 66 |
Mean baseline HbA1c (%) | 7.7 | 8.7 | 8.7 | 8.0 | 8.1 | 8.2 |
Metformin use (%) | 66 | 76 | 73 | 77 | 74 | 77 |
Statin use (%) | 93 | 72 | 73 | 74 | 77 | 75 |
RAAS inhibitor use (%) | 85 | 83 | 84 | 80 | 81 | 80 |
Outcomes (HR [95% CI]) | ||||||
MACEb | 1.02 [0.89–1.17] | 0.87 [0.78–0.97] | 0.74 [0.58–0.95] | 0.91 [0.83–1.00] | 0.86 [0.74–0.99] | 0.86 [0.75 – 0.97] |
CV death | 0.98 [0.78–1.22] | 0.78 [0.66–0.93] | 0.98 [0.65–1.48] | 0.88 [0.76–1.02] | 0.62 [0.49 – 0.77] | 0.87 [0.72–1.06] |
Myocardial infarction | 1.03 [0.87–1.22] | 0.86 [0.73–1.00] | 0.74 [0.51–1.08] | 0.97 [0.85–1.10] | 0.87 [0.70–1.09] | 0.85 [0.69–1.05] |
Stroke | 1.12 [0.79–1.58] | 0.86 [0.71–1.06] | 0.61 [0.38–0.99] | 0.85 [0.70–1.03] | 1.18 [0.89–1.56] | 0.90 [0.71–1.15] |
All-cause death | 0.94 [0.78–1.13] | 0.85 [0.74–0.97] | 1.05 [0.74–1.50] | 0.86 [0.77–0.97] | 0.68 [0.57 – 0.82] | 0.87 [0.74–1.01] |
Hospitalization for heart failure | 0.96 [075–1.23] | 0.87 [0.73–1.05] | 1.11 [0.77–1.61] | 0.94 [0.78–1.13] | 0.65 [0.50 – 0.85] | 0.67 [0.52 – 0.87] |
Composite renal outcomes | – | 0.78 [0.67–0.92] | 0.64 [0.46–0.88] | – | 0.61 [0.53 – 0.70] | 0.60 [0.47–0.77] |
Italic values indicate significance of p value (p < 0.05)
ACS acute coronary syndrome, CI confidence interval, CV cardiovascular, GLP-1RA glucagon-like peptide-1 receptor agonist, MACE major adverse cardiovascular events, HR hazard ratio, RAAS renin–angiotensin–aldosterone system, SGLT2 sodium-glucose cotransporter 2, T2D type 2 diabetes
aPooled data from CANVAS and CANVAS-R
b4-point MACE in the ELIXA trial and 3-point MACE in the other trials