Combination therapy with sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in heart failure patients with type 2 diabetes

🎖️ Top 10% JournalNov 5, 2025BMJ open diabetes research & care

Using both SGLT2 inhibitors and GLP-1 receptor agonists together in heart failure patients with type 2 diabetes

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

The risk of all-cause death was 2.8% in patients receiving SGLT2i and GLP-1 RA compared to 6.3% in those on SGLT2i monotherapy.

Patients treated with both SGLT2i and GLP-1 RA had a significantly lower risk of all-cause death compared to those on SGLT2i alone.
The hazard ratio for all-cause death in the combination therapy group was 0.43, indicating a reduced risk.
Hospitalization risk was also lower in patients receiving both therapies (32.9%) compared to those on SGLT2i monotherapy (36.4%).
The hazard ratio for hospitalization in the combination therapy group was 0.87, suggesting a protective effect.

AI simplified

INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve cardiovascular outcomes in type 2 diabetes (T2D), and SGLT2i reduces events in (HF). However, the benefit of their combination in patients with both conditions remains unclear. This study assessed the risk of all-cause death and hospitalization with combination therapy versus SGLT2i monotherapy.

RESEARCH DESIGN AND METHODS: This multicenter, retrospective, observational study used the TriNetX database between January 1, 2018, and December 31, 2021. We identified 928,981 patients aged ≥18 years with HF and T2D. Of these, 168,422 received an SGLT2i. The exposure group comprised patients who initiated a GLP-1 RA within 6 months of SGLT2i initiation, while the control group included those who did not receive a GLP-1 RA after SGLT2i initiation. The index date was defined as 6 months after SGLT2i. 25,989 patients received SGLT2i and GLP-1 RA and 54,619 received SGLT2i monotherapy. Following propensity score matching, each group comprised 23,240 patients.

RESULTS: Over 1 year, the risk of all-cause death in patients who received SGLT2i and GLP-1 RA relative to those who received SGLT2i monotherapy was significantly lower (2.8% vs 6.3%, p<0.001; HR 0.43; 95% CI 0.39 to 0.48). Similarly, the risk of hospitalization in patients who received SGLT2i and GLP-1 RA was also lower (32.9% vs 36.4%, p<0.001; HR, 0.87; 95% CI 0.84 to 0.90).

CONCLUSIONS: The risk of all-cause death and hospitalization in patients who received combination therapy with SGLT2i and GLP-1 RA relative to those who received SGLT2i monotherapy was significantly lower in patients with HF and T2D.

Key numbers

2.8%

Decrease in all-cause death risk

Risk of all-cause death for and group.

32.9%

Decrease in hospitalization risk

Risk of hospitalization for and group.

Full Text

We can’t show the full text here under this license. Use the link below to read it at the source.

View full text ↗

Abstract

Key numbers

Full Text

Related papers