Evidence mapPaperPMID 41367446Full record

ReviewCureus2025

Cardiorenal Safety Markers With Injectable Glucagon-Like Peptide-1 (GLP-1) Agonists in Type 2 Diabetes: A Network Meta-Analysis.

Abigail Rai, Mahesh Kolli, Gaurav Pratap Singh, Rishu, Chao Yuan Li Cai, Hariharasudhan Balaji, Bendangjungla Pongen, Sandra Joy, Shahid Sai A K

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Abigail RaiAcute Medical Unit (AMU), Impur Christian Hospital, Mokokchung, IND.
Mahesh KolliTelemedicine, Apollo Hospitals, Chennai, IND.
Gaurav Pratap SinghCritical Care Medicine, King's College Hospital NHS Foundation Trust, London, GBR.
RishuGeneral Internal Medicine, Dudley Group of NHS Foundation Trust, Dudley, GBR.
Chao Yuan Li CaiGeneral Medicine, Hywel Dda Health Board, Wales, GBR.
Hariharasudhan BalajiEmergency Medicine, Southern Health and Social Care Trust, Armagh, GBR.
Bendangjungla PongenEmergency Medicine, Bethesda Hospital, Kohima, IND.
Sandra JoyNeurology, Baby Memorial Hospital, Kozhikode, IND.
Shahid Sai A KEmergency Medicine, Baby Memorial Hospital, Thodupuzha, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Type 2 diabetes mellitus (T2DM) markedly increases the risk of cardiovascular and renal complications, emphasizing the need for therapies that extend benefits beyond glycemic control. Injectable glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated both cardioprotective and renoprotective potential, but the comparative efficacy of individual agents remains uncertain. This network meta-analysis (NMA) evaluated and ranked the effects of GLP-1 RAs on major adverse cardiovascular events (MACE) and renal composite outcomes, both prespecified as co-primary endpoints. A systematic search of PubMed, Scopus, ScienceDirect, Web of Science, and the Cochrane Library was conducted from inception to January 2024. Eligible randomized controlled trials enrolled adults with T2DM, including those with or without established cardiovascular disease or chronic kidney disease. Renal composite outcomes were defined as a decline in estimated glomerular filtration rate (eGFR) and/or onset of macroalbuminuria. Direct and indirect evidence were synthesized using a frequentist NMA framework to generate odds ratios (ORs) with 95% confidence intervals (CIs), while treatment hierarchy was assessed with Surface Under the Cumulative Ranking Curve (SUCRA) values. Transitivity and consistency assumptions were tested and satisfied, and the risk of bias was assessed with the Cochrane RoB2 tool. Fifteen randomized trials involving a pooled sample of more than 90,000 participants were included. Efpeglenatide ranked highest for both MACE (OR: 0.74; 95% CI: 0.62-0.87; SUCRA: 81.5%) and renal outcomes (OR: 0.68; 95% CI: 0.57-0.81; SUCRA: 81.33%), underscoring its clinical significance over other effective agents such as albiglutide and semaglutide. Albiglutide, semaglutide, dulaglutide, and liraglutide also provided significant benefits, albeit with lower rankings. No major inconsistency or publication bias was detected. In conclusion, this NMA reinforces the class-wide cardiorenal benefits of GLP-1 receptor agonists while emphasizing variations in efficacy among individual agents, the limited evidence base for certain drugs, and the need for future head-to-head trials specifically designed to evaluate cardiovascular and renal endpoints.

Indexed as

cardio protectionglucagon-like peptide-1 receptor agonistnetwork-meta analysisrenal safetytypes 2 diabetes

Identifiers

PMID41367446
PMCPMC12683079

What Socratic holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.