Efficacy and clinical outcomes of GLP-1 receptor agonists and SGLT-2 inhibitors in diabetics with renal impairment: a Meta-analysis

Objective To evaluate the efficacy of GLP-1 receptor agonists and SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus with renal damage.Methods Based on the keywords of "diabetes mellitus plus kidney injury","GLP-1 receptor agonist" and "SGLT-2 inhibitor",the databases of China National Knowledge Infrastructure(CNKI),VIP,WanFang,Web of Science,PubMed and Embase were searched for randomized controlled trials(RCTs).The retrieval time was from the establishment of the database to January 2022.Meta-analysis was performed by RevMan5.3 software.Results A total of 2146 articles on the efficacy and clinical outcomes of GLP-1 receptor agonists and SGLT-2 inhibitors were retrieved.After screening,8 articles were finally included.Compared with controls,GLP-1 receptor agonists and SGLT-2 inhibitors offered more advantages in lowering HbA1c(MD=-0.36,95%CI:-0.52~-0.19,P＜0.05);GLP-1 receptor agonists and SGLT-2 inhibitors could better reduce the level of eGFR(MD=0.28,95%CI:0.08~0.48,P=0.005);Both GLP-1 receptor agonists and SGLT-2 inhibitors could better reduce UACR(MD=-1.37,95%CI:-1.55~-1.20,P＜0.05).No significant difference existed in adverse reactions between GLP-1 receptor agonist and SGLT-2 inhibitor for varying degrees of renal damage(P＞0.05).Conclusion GLP-1 receptor agonists and SGLT-2 inhibitors have some values in the treatment of diabetics with renal damage.