JAMA Netw Open

GLP-1 RA/thiazolidinedione combo therapy linked to improved survival in T2DM

April 3, 2025

Combining a GLP-1 RA with a thiazolidinedione significantly reduces mortality and CV complications in T2DM patients, although it increases the risk of hypoglycemia. This combination therapy may be considered for patients at high CV risk, with careful monitoring for hypoglycemia.

Study details: This retrospective cohort study utilized nationwide data from Taiwan's National Health Insurance Research Database. It included 110,411 patients with type 2 diabetes, all over 20 years old, who received a GLP-1 RA or thiazolidinedione between January 1, 2011, and December 31, 2020. The analysis compared the risks of all-cause mortality, major adverse cardiovascular events (MACE), CV mortality, CV complications, and hypoglycemia among users of GLP-1 RA and thiazolidinedione combination therapy, monotherapy, and nonusers.

Results: Patients on combination therapy had significantly lower risks of all-cause mortality (adjusted hazard ratio [AHR], 0.20), MACE (AHR, 0.85), and CV mortality (AHR, 0.20) compared with nonusers. However, combination therapy was associated with a higher risk of hypoglycemia (AHR, 1.61), which was mitigated with prolonged use.

Source:

Li JX, et al. (2025, March 3). JAMA Netw Open. Combination of Glucagon-Like Peptide 1 Receptor Agonist and Thiazolidinedione for Mortality and Cardiovascular Outcomes in Patients With Type 2 Diabetes. https://pubmed.ncbi.nlm.nih.gov/40163115/