A real-world study found that adding a GLP-1 to SGLT2 inhibitor therapy was associated with lower kidney, cardiovascular, and mortality risks in CKD. Observational design, potential immortal-time bias, residual confounding, limited dosing/adherence data, and short follow-up constrain causal inference, reinforcing the need for confirmatory randomized trials.SHOW MORE · A real-world study found that adding a GLP-1 to SGLT2 inhibitor therapy was associated with lower kidney, cardiovascular, and mortality risks in CKD. ... Adding a glucagon-like peptide-1 receptor agonist (GLP-1 RA) to ongoing SGLT2 inhibitor therapy was associated with lower risks of kidney disease progression, The FDA has approved belzutifan plus lenvatinib for advanced ccRCC after PD-1/PD-L1 therapy, expanding treatments for those with disease progression. "The addition of a GLP-1 RA to ongoing SGLT2 [inhibitor] therapy is associated with a substantial reduction in the risk of kidney disease progression and cardiovascular events in a real-world setting,” they wrote. "…While confirmatory randomized trials are awaited, these data support the early adoption of combination therapy to address the high residual risk in patients with CKD.” The primary outcome was major adverse kidney events (MAKE), a composite of all-cause mortality, progression to end-stage kidney disease (ESKD), dialysis, stage 5 CKD, or kidney transplant. Over a median follow-up of 12 months, combination therapy was associated with a lower risk of MAKE compared with SGLT2 inhibitor monotherapy (HR, 0.70; 95% CI, 0.65-0.74; P < .001).

Original title: “Combo GLP-1 RA, SGLT2 Therapy Linked to Lower Kidney, CV Risks | AJMC”