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Table 2 Summary of key results

From: Effects of exenatide and open-label SGLT2 inhibitor treatment, given in parallel or sequentially, on mortality and cardiovascular and renal outcomes in type 2 diabetes: insights from the EXSCEL trial

Previous knowledge in the field
Multiple GLP-1 RA and SGLT2i demonstrated benefit on cardiovascular outcomes, mortality, and/or renal disease progression
The mechanisms underlying these effects, while not fully understood, are largely distinct
Combination GLP-1 RA and SGLT2i treatment improves metabolic parameters and cardiovascular risk factors, but no data on cardiovascular events, mortality, or renal function decline is available
New insights from this study
Combination exenatide QW and SGLT2i numerically lowered the hazard ratio for MACE, driven by a significant reduction in cardiovascular death compared to exenatide alone or neither drug class
All-cause mortality risk decreased with the combination, compared to exenatide QW alone or placebo
SGLT2i-mediated eGFR slope improvement was consistent on top of placebo or exenatide QW treatment
This data supports the hypothesis that combination GLP-1 RA and SGLT2i may provide additional cardiovascular and mortality benefit to GLP-1 RA alone, without any increase in risk of hypoglycemia