JAMA Netw Open

GLP-1 RA use may lower CV risk in patients with MGUS and diabetes

July 7, 2025

GLP-1 RA therapy may offer primary prevention benefits for major cardiovascular and renal events in patients with monoclonal gammopathy of undetermined significance (MGUS) and diabetes, a population at heightened risk. Prospective randomized trials are warranted to confirm these observational results before routine adoption in this setting.

Study details: This retrospective cohort study analyzed 4,871 adults with both MGUS and T2DM, using data from the TriNetX Global Database (2018–2023). After excluding those with prior cardiovascular or cerebrovascular disease, 460 GLP-1 RA users were propensity-matched to 460 nonusers. Primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause mortality, new-onset HF, acute coronary syndrome, and stroke or TIA, with secondary endpoints including decompensated HF and kidney outcomes.

Results: GLP-1 RA use was associated with a significantly lower risk of MACCE (hazard ratio [HR], 0.75; 95% confidence interval, 0.60–0.93). Significant reductions were also observed in all-cause mortality (HR, 0.57), new-onset HF (HR, 0.69), decompensated HF (HR, 0.60), and acute kidney injury or end-stage kidney disease (HR, 0.73).

Source:

Chi KY, et al. (2025, June 2). JAMA Netw Open. GLP-1 RA Use and Major Adverse Cardiovascular Events in Patients With Monoclonal Gammopathy of Undetermined Significance. https://pubmed.ncbi.nlm.nih.gov/40587132/