Anemia Risk Lower With SGLT2i vs GLP1-RA in Patients With Both Diabetes, CKD

Anemia risk is lower among patients receiving SGLT2 inhibitors (SGLT2i) compared with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to treat type 2 diabetes and early chronic kidney disease (CKD), according to real-world data.

Among 13,799 patients with type 2 diabetes and stage 1-3 CKD, the risk for composite anemia outcomes was a significant 19% lower for SGLT2i vs GLP-1 RA users, Shih-Chieh Shao, RPh, PhD, of Keelung Chang Gung Memorial Hospital in Taiwan, and colleagues reported in JAMA Network Open. SGLT2i were significantly associated with a 21% lower risk of anemia events, including hemoglobin levels less than 12g/dL in women and less than 13g/dL in men or a clinical diagnosis of anemia.

The investigators calculated that 1 additional composite anemia outcome may be prevented among every 55 patients treated with an SGLT2i for 1 year.

Follow-up data on changes in hemoglobin levels, hematocrit levels, and red blood cell counts over 3 years supported the primary analyses. Results were consistent across sex, age, HbA1c levels, eGFR levels and specific SGLT2 inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, suggesting a class effect.

Anemia treatment initiation (ie, iron, erythropoiesis-stimulating agents, or blood transfusion) occurred in similar proportions of both groups, however.

According to Dr Shao’s team, “these findings may reinforce the proposed mechanism of anemia improvement from SGLT2 inhibitor use through regulation of the hypoxia-inducible factor system and stimulation of [erythropoietin] secretion.”

Of the cohort, 12,331 patients initiated SGLT2i and 1468 initiated GLP-1 RA. Mean age was 62 years.

Read More: SGLT2 Inhibitors for Diabetes May Protect Against AKI, Increase UTI Risk

This article originally appeared on Renal and Urology News