Real-world sex differences in type 2 diabetes patients treated with GLP-1 receptor agonists

• Published in: Diabetes research and clinical practice 2024-06, Vol.212, p.111689-111689, Article 111689
• Main Authors: Piccini, Sara, Favacchio, Giuseppe, Morenghi, Emanuela, Mazziotti, Gherardo, A. Lania, Andrea G., Mirani, Marco
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Diabetes Mellitus, Type 2 - drug therapy; Female; GLP-1 receptor agonists; Glucagon-Like Peptide-1 Receptor - agonists; Humans; Hypoglycemic Agents - therapeutic use; Male; Middle Aged; Real-world; Retrospective Studies; Sex; Sex Factors; Type 2 diabetes
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2024.111689

[Display omitted] •Sex differences relative to CV protection with GLP-1 receptor agonists in type 2 diabetes patients are largely unknown.•The determinants of CV protection were different between men and women in our cohort.•GLP-1 RA treatment withdrawal by time was associated to MACE risk, except in women with previous CV events. To evaluate the determinants of cardiovascular (CV) protection in men and women treated with glucagon-like peptide-1 receptor agonists (GLP1-RA). Retrospective cohort study of 550 patients (43% women), with and without established CV disease, followed at a single center after the first prescription of a GLP1-RA. We analyzed the determinants of major adverse cardiovascular events (MACE) in men and women. The rate of MACE was similar between sexes. In primary prevention, among men, older age (HR 1.13, 95 % C.I. 1.05–1.22; P = 0.001) and GLP-1 RA withdrawal by time (HR 2.77, 95 % C.I. 1.15–6.68; P = 0.023) increased the HR for MACE. Among women, significant predictors of MACE were diabetes duration (HR 1.05, C.I. 1.01–1.10; P = 0.020), GLP-1 withdrawal by time (HR 2.84, 95 % C.I. 1.13–7.10; P = 0.026) and BMI at GLP-1 RA withdrawal (HR 1.08, 95 % C.I. 1.01–1.15; P = 0.026). For individuals with prior CV disease, the HR for MACE was solely impacted by GLP-1 withdrawal over time in males (HR 2.18, 95 % C.I. 1.10–4.30; P = 0.025) and by older age at GLP-1 RA initiation (HR 1.17, 95 % C.I. 1.03–1.33; P = 0.015) in females. Although MACE rates were similar, the factors contributing to MACE differed by sex.