A retrospective cohort from the TriNetX global network compared adults with chronic kidney disease on an SGLT2 inhibitor alone with those who subsequently added a GLP-1 receptor agonist, matching 16,224 patients per group. Over a median of 12 months, combination therapy was associated with hazard ratios of 0.70 for major adverse kidney events, 0.83 for major adverse cardiovascular events and 0.55 for all-cause mortality. Gastrointestinal symptoms, genital infections and retinopathy progression were more common, and volume depletion and acute kidney injury less so.
Why it is interesting: A real-world comparison of combined incretin and SGLT2 inhibitor therapy, where the size of the mortality association in an observational cohort leaves confounding by indication open.