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COMPARISON OF EFFICACY OF SGLT2 INHIBITORS AND GCRA ANTAGONISTS IN CARDIOVASCULAR AND RENAL OUTCOMES FOR PATIENTS WITH DIABETIC NEPHROPATHY: A META-ANAL-YSIS

DAN ZHANG, YANYAN WU *

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This meta-analysis evaluated the effects of sodium–glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on major adverse cardiovascular events (MACE) and renal outcomes in patients with diabetic nephropathy (DN). A systematic search of Embase, PubMed, MEDLINE, and Web of Science identified relevant studies pub- lished up to February 2024. Eligible trials comparing SGLT2 inhibitors or GLP-1 RAs with control therapies were analyzed using RevMan 5.3. Thirteen studies involving 69,754 patients with diabetes and impaired renal function were included. SGLT2 inhibitors significantly reduced the risk of MACE, cardiovascular death, fatal or non-fatal myocardial infarction, stroke, and composite renal outcomes compared with controls. GLP-1 RAs also lowered MACE, cardiovascular death, and stroke risk, although no significant benefit was observed for myocardial infarction or renal composite endpoints. Safety analysis showed no significant differences in urinary tract infections versus controls; however, SGLT2 inhibitors were associated with a higher risk of severe hypoglycemia, while GLP-1 RAs showed no notable safety concerns. Overall, both drug classes demonstrate cardiovascular benefits in DN, and treatment selection should be individualized according to patient characteristics and clinical context.