Racial, Ethnic Differences Seen for Benefits of Antihyperglycemic Agents

THURSDAY, Sept. 28, 2023 (HealthDay News) -- There are racial/ethnic differences in the cardiorenal effects of sodium-glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP1-RAs) in patients with type 2 diabetes, according to a review published online Sept. 21 in the Journal of the Royal Society of Medicine.

Setor K. Kunutsor, M.D., Ph.D., from University of Leicester in the United Kingdom, and colleagues conducted a systematic literature review and meta-analysis to compare racial/ethnic as well as regional pattern effects for SGLT2is and GLP1-RAs on cardiovascular disease (CVD) and renal outcomes in patients with type 2 diabetes.

Based on 14 included trials, the researchers found that the risk for major adverse cardiovascular events (MACE) varied with SGLT2is by race (White: hazard ratio [HR], 0.92; Asian: HR, 0.69; Hispanic/Latino: HR, 0.70) versus placebo. Similar results were seen for GLP1-RAs versus placebo (HRs, 0.88, 0.76, and 0.82, respectively). For other cardiorenal outcomes, SGLT2is reduced the risk in White and Asian populations, except for heart failure hospitalizations in Asians. There were no effects found in Black populations except for a reduced risk for heart failure hospitalizations by SGLT2i. The risk for composite CVD death/heart failure hospitalization was reduced with SGLT2-Is in North America and Europe, while GLP1-RAs cut the risk for MACE in Europe. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) certainty of evidence ranged from moderate to high.

"Whether the differences are due to issues with underrepresentation of Black populations and low statistical power or racial/ethnic variations in the pharmacokinetics, pharmacodynamics, and safety of SGLT2-Is and GLP1-RAs needs further investigation," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text