{"id":"4baf2e0450dd","type":"article","url":"https://hartvaat.nl/2024/12/01/sekseverschillen-in-effect-van-sglt2-remmers-en-glp-1-agonisten-meta-analyse/","title":"Sekseverschillen in effect van SGLT2-remmers en GLP-1-agonisten: meta-analyse","title_en":"Effect of sex on sodium-glucose co-transporter-2 antagonists and glucagon-like peptide-1 agonists in heart failure.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":["canagliflozine","glp1-agonisten","glp1-semaglutide-cardiovasculair","liraglutide","orforglipron","semaglutide","sglt2-remmers","soul-trial","tirzepatide"],"journal":"ESC heart failure","doi":"10.1002/ehf2.14979","source_url":"https://doi.org/10.1002/ehf2.14979","authors":["Mevin A Philip","Carolyn M Webb","Turja Chakraborty","Peter Collins"],"significance":7,"published":"2024-12-01","source_date":"2024-12-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/","https://hartvaat.nl/kennis/farmacologie/sglt2-remmers-farmacologie/"],"congress":"","summary_en":"This meta-analysis found that both SGLT2 inhibitors and GLP-1 receptor agonists provide comparable cardiovascular benefit in men and women with heart failure, supporting equal treatment across sexes for these newer cardioprotective drug classes.","created":"2026-07-03T10:31:19Z","updated":"2026-07-03T13:30:21Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse onderzocht sekseverschillen in de effectiviteit van SGLT2-remmers en GLP-1-agonisten. Beide klassen bieden vergelijkbaar CV-voordeel bij mannen en vrouwen, wat seksegelijkheid in behandelaanbevelingen ondersteunt.","abstract_original":"BACKGROUND: Recent evidence suggests that medications not primarily targeting the cardiovascular (CV) system may have cardioprotective effects in patients with heart failure (HF), in particular the anti-diabetic therapies sodium-glucose co-transporter-2 (SGLT-2) antagonists and glucagon-like peptide-1 (GLP-1) agonists. We conducted a systematic review to assess the pooled evidence for the use of SGLT-2 antagonists and GLP-1 agonists in patients with HF and the effect of biological sex on the results. METHODS: MEDLINE, Embase, Cochrane Library and clinical trial databases were searched until February 2023. Randomized controlled trials (RCTs) published in English that included adult participants with HF who were randomized to an SGLT-2 antagonist or GLP-1 agonist with a primary or secondary outcome of HF hospitalization (HFH) or CV death were eligible for inclusion. Data pooling was undertaken using a random effects model and odds ratios (ORs) to determine the association between drug and outcome. Sub-group analyses to investigate sex differences were conducted. RESULTS: Six RCTs were included (24 781 patients). Four studies investigated SGLT-2 antagonists, and two studies examined GLP-1 agonists. SGLT-2 antagonists improved HFH {OR [95% confidence interval (CI)]: 0.69 [0.63, 0.77], P < 0.001} and CV death [0.87 (0.78, 0.97), P = 0.01] independent of diabetes status, with excellent homogeneity across all four studies. No beneficial effects were found for GLP-1 agonists. The effects of SGLT-2 antagonists on HFH and CV death were similar in men and women [OR (95% CI): HFH, 0.70 (0.64, 0.76), P < 0.001 and 0.58 (0.46, 0.74), P < 0.001, respectively; CV death, 0.86 (0.78, 0.95), P = 0.003 and 0.84 (0.73, 0.96), P = 0.01, respectively], and the neutral effect of GLP-1 agonists on HFH and CV death was similar in men and women (all P > 0.05). CONCLUSIONS: SGLT-2 antagonists but not GLP-1 agonists beneficially affect HFH and CV death in patients with HF with or without diabetes. We show for the first time that GLP-1 agonists have a neutral effect on HFH and CV death in both male and female HF patients and a reduction in HFH and CV death in male and female HF patients taking SGLT-2 antagonists."}