Evidence mapPaperPMID 41874854Full record

SynthesisAdvances in therapy2026

Evidence-Based Positioning of Sodium-Glucose Co-transporter 2 Inhibitors and Glucagon-Like Peptide 1 Receptor Agonists in the Management of Chronic Kidney Disease with Type 2 Diabetes and Overweight or Obesity: A Systematic Literature Review.

Yehuda Handelsman, Alice Y Y Cheng, Gian Paolo Fadini, Pam Kushner, Fabrice Bonnet, Paola Fioretto, Takashi Kadowaki, Naresh Kanumilli, Xavier Cos, Thomas Frese and 5 more

Abstract readSystematic Review
In one paragraph

Synthesis in Advances in therapy, 2026. 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

15 authors.

Yehuda HandelsmanMetabolic Institute of America, Los Angeles, CA, USA.
Alice Y Y ChengUniversity of Toronto, Toronto, Canada.
Gian Paolo FadiniDepartment of Medicine, University of Padova, Padua, Italy.
Pam KushnerUniversity of California Irvine Medical Center, Orange, CA, USA.
Fabrice BonnetUniversity of Rennes, Rennes, France.
Paola FiorettoDepartment of Medicine, University of Padova, Padua, Italy.
Takashi KadowakiToranomon Hospital, Tokyo, Japan.
Naresh KanumilliNorthenden Group Practice, Wythenshawe, UK.
Xavier CosIDIAP Jordi Gol, Institut Català de la Salut, CIBERDEM, Barcelona, Spain.
Thomas FreseInstitute of General Practice and Family Medicine, Interdisciplinary Center of Health Sciences, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle / Saale, Germany.
Linong JiPeking University People's Hospital, Beijing, China.
Molly MurtonCostello Medical, Cambridge, UK.
Simon FoulcerAstraZeneca, Cambridge, UK.
Surendra PentakotaAstraZeneca, Cambridge, UK.
Peter RossingUniversity of Copenhagen, Copenhagen, Denmark. Peter.Rossing@RegionH.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBoth sodium-glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have demonstrated kidney benefits in adults with chronic kidney disease (CKD) with type 2 diabetes (T2D) and overweight/obesity. However, questions remain regarding the optimal positioning, combination and sequencing of the two drug classes. This systematic literature review (SLR) identified evidence on comparisons, combinations or sequencing of SGLT2is and GLP-1 RAs in this population.

methodsDatabases were searched in May 2025. Relevant congresses between 2023 and 2025, SLR bibliographies and ClinicalTrials.gov were hand-searched. Articles were screened by two independent reviewers. Kidney and composite kidney outcomes were prioritised as the most clinically relevant for a population with CKD; additional safety, cardiovascular, HbA1c and weight endpoints were also extracted.

resultsElectronic databases identified 922 records, with an additional 117 records from hand searches. In total, 48 publications were included reporting on 38 unique studies; comprising 11 meta-analyses (MAs) and 27 primary publications. Findings from MAs consistently favoured SGLT2is over GLP-1 RAs for composite kidney outcomes. Primary research studies showed no clear direction of benefit for change in estimated glomerular filtration rate (eGFR) or albuminuria from baseline, or eGFR decline. However, progression of kidney disease, where reported, was consistently reduced with SGLT2is versus GLP-1 RAs.

conclusionIn the absence of head-to-head trials, the evidence identified supports the use of SGLT2is as a foundational therapy in adults with CKD and T2D, offering kidney protection, metabolic and cardiovascular benefits, with GLP-1 RAs positioned as a complementary adjunct. PROSPERO ID: CRD420251053598.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsObesityOverweightRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsHumansGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsChronic kidney diseaseGlucagon-like peptide 1 receptor agonistObesitySodium-glucose co-transporter 2 inhibitorType 2 diabetes

Identifiers

PMID41874854
PMCPMC13156165

What Socratic holds

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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.