GLP-1 Receptor Agonists and Risk of Adverse Cerebrovascular Outcomes in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
J Clin Endocrinol Metab. 2023; online ahead of print DOI: 10.1016/j.jacc.2022.07.021 10.1210/clinem/dgad076
Although the beneficial effects of GLP-1RAs on major cardiovascular events have been established in patients with T2D, their effects on cerebrovascular outcomes remain undetermined.
A systematic review identified 28 RCTs of ≥24 weeks duration involving 74,148 patients with T2D. GLP-1 RAs use was associated with a significant 17% decreased risk of adverse cerebrovascular outcomes vs placebo/active comparator. GLP-1RA treatment vs placebo was associated with reduced risk of ischaemic stroke and nonfatal stroke, but not fatal stroke or haemorrhagic stroke. Observed benefits were significantly higher in patients with shorter T2D duration and higher eGFR, and were significant with dulaglutide and semaglutide.