Meta-analyses of results from randomized outcome trials comparing cardiovascular effects of SGLT2i and GLP-1RA in Asian vs. White patients with and without type 2 diabetes

Previous cardiovascular outcome trials (CVOTs) suggest that greater benefit might be derived to Asians with newer classes of antihyperglycemic medications as compared to Whites. Nazim Ghouri MD and colleagues published a meta-analysis in the Diabetes Journal under the title “Meta-analyses of results from randomized outcome trials comparing cardiovascular effects of SGLT2i and GLP-1RA in Asian vs. White patients with and without type 2 diabetes”. The summary of this analysis is given below:

Objective:

To summarize hazard ratio (HR) estimates for cardiovascular efficacy of sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide receptor agonists (GLP-1RA) in Asian and White populations.

Method:

This systematic review was performed in PubMed between January 01, 2015, to December 08, 2020.Randomized placebo-controlled CVOTs of SGLT2is and GLP-1RAs that reported HR (95% CI) for (i) major adverse cardiovascular events (MACE), and (ii) cardiovascular (CV) death/ and hospitalization for heart failure (HHF) were selected. To investigate differences between the selected outcomes in Asians vs. Whites, a random-effects meta-analysis was conducted.

Findings:

This study suggests differential treatment effect as per ethnicity with greater benefits of SGLT2is and GLP-1RAs on Asians as compared to Whites. Additionally, MACE benefits derived by GLP-1RAs were significantly better in Asians compared to Whites.

Limitation:

The study has several limitations such as lack of individual patient-level data, period of trial to be relatively short, and lack of granular categorization of the race with the broadly-defined Asian subgroups.
Authors acknowledge future studies with individual participant meta-analyses.

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