Comparable Cardiorenal Benefits of SGLT2 Inhibitors and GLP1RAs in Asian and White Populations: An Updated Meta-analysis of Results From Randomized Outcome Trials

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BACKGROUND Whether the cardiorenal benefits of sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are comparable between White and Asian populations remains unclear. PURPOSE To compare the cardiorenal benefits of SGLT2 inhibitors and GLP-1RAs between White and Asian populations and to compare the cardiorenal benefits between the two agents in Asian population. DATA SOURCES Electronic databases were searched up to March 28, 2021. STUDY SELECTION We included the cardiovascular (CV) and renal outcome trials of SGLT2 inhibitors and GLP-1RAs that reported major adverse cardiovascular events (MACE), CV death/heart failure hospitalization (HHF), or composite renal outcomes stratified by race. DATA EXTRACTION AND SYNTHESIS We calculated the pooled hazard ratios using random-effects models, tested the treatment effects between Asian and White groups using meta-regression analysis, and compared the treatment effects between SGLT2 inhibitors and GLP-1RAs in Asian population using a network meta-analysis. RESULTS In 10 SGLT2 inhibitor trials, there was no significant difference between Asian and White populations for MACE (p = 0.55), CV death/HHF (p = 0.87), or composite renal outcomes (p = 0.97). In seven GLP-1RA trials, we observed a similar MACE benefit between Asian and White populations (p = 0.10). Our network meta-analysis found a comparable benefit in MACE between SGLT2 inhibitors and GLP-1RAs in Asian population. LIMITATIONS The data were from stratified analyses. CONCLUSIONS There appear to be comparable cardiorenal benefits of SGLT2 inhibitors and GLP-1RAs between Asian and White participants enrolled in CV and renal outcome trials; the two therapies seem to have similar CV benefits within Asian population.

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