Cardiorenal benefits of glucagon-like peptide-1 analogues vs. exendin-4 analogues in patients with type 2 diabetes: a meta-analysis based on cardiovascular outcome trials.

Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) are one of the novel classes of hypoglycaemic drugs. Beyond glycaemic control and the vasodilator and natriuretic effect, GLP-1RAs exert cardiorenal protection via the following approaches: reducing blood pressure and lipid levels, improving endothelial function, and suppressing vascular inflammation and oxidative stress.1 According to the difference in their structural basis, GLP-1RAs are divided into two subclasses: GLP-1 analogues and exendin-4 analogues. Three cardiovascular outcome trials (CVOTs)2–4 have assessed the cardiorenal efficacy of exendin-4 analogues vs. placebo in patients with type 2 diabetes (T2D), while five CVOTs5–9 have assessed that of GLP-1 analogues vs. placebo in patients with T2D. However, the relative cardiorenal efficacy of these two subclasses of GLP-1RAs is unestablished, due to the absence of head-to-head CVOTs comparing GLP-1 analogues vs. exendin-4 analogues. Hence, we aimed to, by including these placebo-controlled CVOTs2–9 of GLP-1RAs, conduct subgroup meta-analyses and network...