ArticleEClinicalMedicine2025
Comparative cardiovascular effectiveness of newer glucose-lowering drugs in elderly with type 2 diabetes: a target trial emulation cohort study.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
3 citing papers in PubMed.
- Comparative Cardiovascular Effectiveness of Glucagon-Like Peptide 1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors in Diabetes Mellitus.Journal of the American College of Cardiology · 2026Article
- Relation between albuminuria levels and the incidence of cardiovascular events in adult population in Northern Mexico: A 5-year follow-up survival analysis.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Frailty-Informed Deprescribing of Glucose-Lowering Therapy in Older Adults with Type 2 Diabetes: A Pragmatic Clinical Framework.Clinical interventions in aging · 2026Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Reducing risk of cardiovascular disease is crucial in managing type 2 diabetes (T2D). This study assessed the comparative cardiovascular effectiveness of newer glucose-lowering drugs in real-world elderly individuals with T2D, and examined how age modified these effects. Methods: We conducted a cohort study using Danish nationwide registries to emulate a three-arm randomized clinical trial. Participants aged ≥70 years were new users of glucagon-like peptide 1 receptor agonists (GLP1-RAs), sodium-glucose cotransporter 2 inhibitors (SGLT-2is), or dipeptidyl peptidase 4 inhibitors (DPP-4is), between 2012 and 2020. We estimated the overall and age-specific incidence rate ratios (IRR) of 3-point major adverse cardiovascular events (3P-MACE) and hospitalization for heart failure (HHF) using Poisson regression models. Summarized weights were used to balance baseline characteristics and treatment adherence. Findings: The study included 35,679 participants (DPP-4is: 21,848 (62%), GLP1-RAs: 5702 (16%), SGLT-2is: 8129 (23%)). In the as-treated analysis, GLP1-RAs and SGLT-2is were associated with significantly reduced rates of 3P-MACE and HHF compared to DPP-4is. The overall IRR for 3P-MACE was 0.68 (95% CI 0.65-0.71) (GLP1-RAs vs. DPP4is) and 0.65 (95% CI 0.63-0.68) (SGLT-2is vs. DPP4is), while for HHF the IRR was 0.81 (95% CI 0.74-0.88) (GLP1-RAs vs. DPP4is) and 0.60 (95% CI 0.55-0.66) (SGLT-2is vs. DPP4is). These effects were predominantly independent of age. No significant difference was observed between SGLT-2is and GLP1-RAs on 3P-MACE, however, SGLT-2is were associated with a significant reduction of HHF, compared to GLP1-RAs, with an overall IRR of 0.75 (95% CI 0.67-0.83), and with age-dependent variations for both outcomes. Interpretation: In the elderly, use of GLP1-RAs and SGLT-2is was associated with reduced rates of 3P-MACE and HHF compared to DPP-4is, independent of age. SGLT-2is were also associated with reduced rates of HHF compared to GLP1-RAs, largely independent of age, in this population of individuals aged 70 years and above. This provides real-world evidence on the comparative cardiovascular effectiveness of the three most recent glucose-lowering medications and may help strengthen implementation of guidelines into clinical practice. Funding: None.
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