Evidence mapPaperPMID 41523725Full record

ReviewCureus2026

Comparative Effectiveness of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors Versus Glucagon-Like Peptide-1 (GLP-1) Agonists on Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.

Aymen A Alqurain, Manal Salem, Bashayer A Algarzai, Eman M Eljadi, Hazem S Elsayed, Ahmed Almuhanna, Deema S Albuhayji, Mohammad Salami, Joud Alzahrani, Juri Alsayyali and 4 more

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
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

14 authors.

Aymen A AlqurainClinical Practice, Faculty of Pharmacy, Northern Border University, Rafha, SAU.
Manal SalemMedical Education and Simulation, Al Baha University, Al-Baha, SAU.
Bashayer A AlgarzaiPharmacy, Qassim University, Al-Qassim, SAU.
Eman M EljadiClinical Pharmacy, Misurata Health Services Center, Misurata, LBY.
Hazem S ElsayedClinical Pharmacy, Cairo University Hospitals, Cairo, EGY.
Ahmed AlmuhannaClinical Pharmacy, King Faisal University, Al-Ahsa, SAU.
Deema S AlbuhayjiPharmacy, Qassim University, Al-Qassim, SAU.
Mohammad SalamiPharmacy, King Abdulaziz Hospital, Ministry of National Guard - Health Affairs, Al-Ahsa, SAU.
Joud AlzahraniMedical School, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Juri AlsayyaliMedicine and Surgery, King Abdulaziz University, Jeddah, SAU.
Abdulrahman AlqarniGeneral Practice, Ministry of Defense (MOD), Tabuk, SAU.
Nessreen AlqahtaniNursing, King Abdulaziz University Hospital, Jeddah, SAU.
Fay T AlotaibiPharmacy, Shaqra University, Shaqra, SAU.
Gharam G AlyamiPharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, SAU.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular and renal risks in type 2 diabetes mellitus (T2DM), but their relative efficacy remains uncertain due to the absence of direct comparative trials. This systematic review and network meta-analysis aimed to evaluate the efficacy and safety of interventions concerning major adverse cardiovascular events (MACE), heart failure, and renal outcomes. A systematic review and network meta-analysis of large-scale, placebo-controlled cardiovascular outcome trials was conducted. PubMed, Embase, and CENTRAL were searched for trials published up to December 2025. The primary outcome was MACE (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke). The secondary outcomes included hospitalization for heart failure (HHF), composite renal outcomes, and all-cause mortality. The evaluated safety outcomes included severe hypoglycemia, diabetic ketoacidosis, amputation, fracture, and genital infections. Data were pooled using a frequentist random-effects model. In total, 14 trials involving 117,633 participants were included. Both drug classes reduced the risk of MACE compared with placebo (SGLT2i: hazard ratio (HR) = 0.89, 95% confidence interval (CI) = 0.84-0.94; GLP-1RA: HR = 0.86, 95% CI = 0.80-0.93), with no statistically significant difference observed between the two (HR = 1.03, 95% CI = 0.94-1.13). SGLT2 inhibitors had a greater efficacy than GLP-1 receptor agonists in reducing HHF (HR = 0.75, 95% CI = 0.66-0.85) and composite renal outcomes (HR = 0.76, 95% CI = 0.66-0.87). Similarly, both classes lowered all-cause mortality. SGLT2 inhibitors exhibited an elevated risk of genital infections (relative risk (RR) = 3.49, 95% CI = 2.63-4.55) and diabetic ketoacidosis (RR = 2.36, 95% CI = 1.33-4.17) compared to GLP-1 receptor agonists. SGLT2 inhibitors and GLP-1 receptor agonists are equally effective in preventing MACE. However, SGLT2 inhibitors offer enhanced protection against heart failure and renal disease progression, whereas GLP-1 receptor agonists exhibit a more favorable safety profile for genital infections and ketoacidosis. These findings support a phenotype-specific treatment approach for patients with T2DM.

Indexed as

cardiovascular outcomeschronic kidney diseasecomparative effectivenessglp-1 receptor agonistsheart failurenetwork meta-analysissglt2 inhibitorstype 2 diabetes

Identifiers

PMID41523725
PMCPMC12781563

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.