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Study · Systematic review · 2025

3 results

Clinical efficacy and safety of sodium-glucose cotransporter protein-2 (SGLT-2) inhibitor, glucagon-like peptide-1 (GLP-1) receptor agonist, and Finerenone in type 2 diabetes mellitus with non-dialysis chronic kidney disease: a network meta-analysis of randomized clinical trials.

Guo J, Wei M, Zhang W, Jiang Y, Li A, Wang C, Yin D, Sun A, Gong Y

Frontiers in pharmacology27 Mar 2025Cited by 6 (Europe PMC)

PMID40213686 (opens in a new tab)PMCIDPMC11983143 (opens in a new tab)DOI10.3389/fphar.2025.1517272 (opens in a new tab)PepBankPUB-40213686
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Summary

ObjectiveTo investigate the safety and clinical efficacy of sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists and Finerenone in treating patients with type 2 diabetes mellitus (T2DM) combined with non-dialysis chronic kidney disease (CKD).MethodsCochrane Library, PubMed, EMBASE, Web of Science, CNKI, CQVIP database, and WanFang from their inception up to November 2023 were searched to compare the efficacy and safety of SGLT-2 inhibitors, GLP-1 RA receptor agonists and Finerenone in the treatment of T2DM patients with non-dialysis CKD. To assess the methodological quality and risk of bias in the included studies, we utilized the Cochrane Risk of Bias Assessment tool (RoB 2.0). The confidence of evidence was examined using Confidence in Network Meta-Analysis (CINeMA). Traditional meta-analysis of variables was conducted using Stata 17.0 software with a random-effects model. We assessed publication bias using funnel plots and explored potential sources of heterogeneity through subgroup analysis.ResultsA total of 39 studies (99,599 patients) were included. Compared to Placebo (PBO), SGLT-2 inhibitors demonstrated superior efficacy in reducing glycosylated hemoglobin (HbA1c) (MD = -0.33; 95%CI: from -0.52 to -0.15), systolic blood pressure (SBP) (MD from -5.52 to -1.50; 95%CI from -8.80 to -0.23), body weight (MD from -3.81 to -1.29; 95%CI from -6.34 to -0.84) and diastolic blood pressure (DBP) (MD = -1.86; 95%CI: -3.18, -40.54). The efficacy of Liraglutide in reducing Low-Density Lipoprotein Cholesterol (LDL-C) surpassed that of other agents (MD from -1.58 to -1.41; 95%CI from -2.05 to -0.81). Finerenone significantly reduced SBP (MD = -1.65; 95%CI: -2.48, -0.81) compared to PBO. According to the SUCRA based relative ranking of treatments, Empagliflozin was the most effective in reducing HbA1c and DBP. Semaglutide was the least harmful to estimated glomerular filtration rate. Liraglutide was the most effective in reducing LDL-C. Bexagliflozin, Canagliflozin were the most effective in reducing SBP and body weight. Finerenone had the lowest incidence of urinary tract infection, Hypoglycemia was the lowest in the Luseogliflozin group. Ertugliflozin was the least likely to cause acute kidney injury. Canagliflozin had the lowest probability of any adverse event.ConclusionThe safety of these drugs has been confirmed, except for some special drugs. SGLT-2 inhibitors had a preferential glucose-lowering and weight-loss function, GLP-1 receptor agonists had a preferential lowering of LDL-C and blood glucose, and Finereone significantly reduced SBP compared with PBO. Systematic Review Registration: PROSPERO, CRD42024571544.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study3

3 results from studies that gave the peptide. 3 results from people.

  1. 01HumanSystematic reviewEfficacy outcome

    In reviewed T2D patients with non-dialysis CKD, liraglutide surpassed other agents for LDL-C reduction (reported MD range -1.58 to -1.41; CI range -2.05 to -0.81); units and individual contrast references were unstated.

    In plain wordsIn T2D patients with non-dialysis CKD, liraglutide lowered LDL cholesterol more than other network medicines.

    Peptide
    Liraglutide
    Outcome
    DecreaseLDL-C
    Study

    n: not reported in source

    Comparator
    Other agents
    Outcome group
    Lipids · Metabolic and weight
    Studied dose
    Dose not stated

    Measurements

    Mean difference
    −1.58 to −1.41
    liraglutide versus other agents
    95% CI
    −2.05 to −0.81
    liraglutide versus other agents

    Source sentences

    Summary
    The efficacy of Liraglutide in reducing Low-Density Lipoprotein Cholesterol (LDL-C) surpassed that of other agents (MD from -1.58 to -1.41; 95%CI from -2.05 to -0.81).
    2 context sentences
    Summary · context
    Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, CQVIP database, and WanFang from their inception up to November 2023 were searched to compare the efficacy and safety of SGLT-2 inhibitors, GLP-1 RA receptor agonists and Finerenone in the treatment of T2DM patients with non-dialysis CKD.
    Summary · context
    The confidence of evidence was examined using Confidence in Network Meta-Analysis (CINeMA). Traditional meta-analysis of variables was conducted using Stata 17.0 software with a random-effects model.
  2. 02HumanSystematic reviewSafety outcome

    In people with type 2 diabetes and non-dialysis chronic kidney disease, semaglutide was the least harmful to estimated glomerular filtration rate.

    In plain wordsIn T2D patients with non-dialysis CKD, semaglutide ranked least harmful to kidney filtration among network treatments.

    Peptide
    Semaglutide
    Outcome
    Not applicableEstimated glomerular filtration rate safety ranking
    Study

    n: not reported in source

    Comparator
    Other treatments
    Outcome group
    Kidney function · Kidney and urinary
    Studied dose
    Dose not stated

    Source sentences

    Summary
    Semaglutide was the least harmful to estimated glomerular filtration rate.
    2 context sentences
    Summary · context
    According to the SUCRA based relative ranking of treatments, Empagliflozin was the most effective in reducing HbA1c and DBP.
    Summary · context
    Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, CQVIP database, and WanFang from their inception up to November 2023 were searched to compare the efficacy and safety of SGLT-2 inhibitors, GLP-1 RA receptor agonists and Finerenone in the treatment of T2DM patients with non-dialysis CKD.
  3. 03HumanSystematic reviewEfficacy outcome

    In reviewed T2D patients with non-dialysis CKD, liraglutide was the most effective network treatment for LDL-C reduction; no numerical rank probability was reported.

    In plain wordsIn T2D patients with non-dialysis CKD, liraglutide ranked most effective among network treatments for LDL cholesterol reduction.

    Peptide
    Liraglutide
    Outcome
    Not applicableLDL-C reduction efficacy ranking
    Study

    n: not reported in source

    Comparator
    Other network treatments
    Outcome group
    Lipids · Metabolic and weight
    Studied dose
    Dose not stated

    Source sentences

    Summary
    Liraglutide was the most effective in reducing LDL-C.
    2 context sentences
    Summary · context
    According to the SUCRA based relative ranking of treatments, Empagliflozin was the most effective in reducing HbA1c and DBP.
    Summary · context
    Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, CQVIP database, and WanFang from their inception up to November 2023 were searched to compare the efficacy and safety of SGLT-2 inhibitors, GLP-1 RA receptor agonists and Finerenone in the treatment of T2DM patients with non-dialysis CKD.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 3Current

    12 Oct 2026, 11:11 UTC

    Study results updated

  2. Version 2

    9 Oct 2026, 03:06 UTC

    Study data updated · source update from Europe PMC

  3. Version 1

    9 Oct 2026, 03:05 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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