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Min et al. Metab Target Organ Damage 2023;3:6 Metabolism and
DOI: 10.20517/mtod.2023.09
Target Organ Damage

Review Open Access

Cardiovascular outcome trials of GLP-1RAs and
SGLT-2 inhibitors: a concise review from the

clinicians’ perspective

3
3
1,2
Thinzar Min , Elin Crockett , Andreas Pavlou , Stephen C Bain 1,3
1
Diabetes Research Group, Swansea University Medical School, Swansea SA2 8PP, UK.
2
Department of Diabetes and Endocrinology, Neath Port Talbot Hospital, Swansea Bay University Health Board, Swansea SA12
7BX, UK.
3
Department of Diabetes and Endocrinology, Singleton Hospital, Swansea Bay University Health Board, Swansea SA2 8QA, UK.
Correspondence to: Dr. Thinzar Min, Diabetes Research Group, Swansea University Medical School, Grove Building, Singleton
Campus, Swansea University, Swansea SA2 8PP, UK. E-mail: Thinzar.Min@swansea.ac.uk
How to cite this article: Min T, Crockett E, Pavlou A, Bain SC. Cardiovascular outcome trials of GLP-1RAs and SGLT-2 inhibitors:
a concise review from the clinicians’ perspective. Metab Target Organ Damage 2023;3:6.
https://dx.doi.org/10.20517/mtod.2023.09

Received: 17 Feb 2023 First Decision: 7 Apr 2023 Revised: 24 Apr 2023 Accepted: 9 May 2023 Published: 16 May 2023

Academic Editors: Stefano Ballestri, Amedeo Lonardo Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Prevention of cardiovascular disease (CVD) is one of the main objectives in the management of people with type 2
diabetes (T2DM). New glucose-lowering therapies such as glucagon-like peptide-1 receptor agonists (GLP-1RAs)
and sodium-glucose cotransporter-2 (SGLT-2) inhibitors have demonstrated not only cardiovascular safety but
also cardiovascular benefits. In line with emerging evidence from the cardiovascular outcome trials (CVOTs),
major international guidelines advocate GLP-1RAs and SGLT-2 inhibitors with proven cardiovascular benefits as a
first add-on or monotherapy in individuals with T2DM and established CVD or CVD risk factors. Based on
subsequent cardiorenal outcomes and heart failure trials, the licensed indications of some SGLT-2 inhibitors have
been extended beyond glycaemic management. SGLT-2 inhibitors have now been approved for the management of
chronic heart failure and chronic kidney disease, both irrespective of diabetes status. This review aims to
summarise the CVOTs of GLP-1RAs and SGLT-2 inhibitors from the clinician’s perspective.
Keywords: CVOT, cardiovascular disease, type 2 diabetes, GLP-1RA, SGLT-2 inhibitor

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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