Scholarlink

Background <p>The impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on peripheral artery disease (PAD) remains uncertain. We assessed the association between GLP-1RA use and major limb events in individuals with type 2 diabetes (T2D) and PAD.</p> Methods <p>We performed a literature search from inception to 31 March 2026 for randomized controlled trials and cohort studies comparing GLP-1RA use versus placebo, active comparators or non-use on lower limb outcomes in individuals with T2D and PAD. The primary outcome was a composite of major limb events, as defined by the investigators of the original studies included in the meta-analysis. Secondary outcomes included lower extremity amputation (LEA), revascularization, gangrene, major adverse cardiovascular events (MACE) and all-cause mortality. Subgroup analyses, leave-one-out sensitivity analyses, and meta-regression analysis were also performed.</p> Results <p>Twelve studies (2 RCTs and 10 matched cohort studies) with thirteen arms involving 418,282 participants were included. Treatment with GLP-1RAs was associated with a significantly lower risk of major limb events by 27% (thirteen arms, RR 0.73, 95% CI 0.65–0.82). Reduced risks were also observed for LEA (RR 0.76, 95% CI 0.66–0.87), revascularization (RR 0.81, 95% CI 0.77–0.86), gangrene (RR 0.80, 95% CI 0.77–0.85), MACE (RR 0.76, 95% CI 0.63–0.90) and all-cause mortality (RR 0.67, 95% CI 0.61–0.73). Subgroup and sensitivity analyses did not substantially change point estimates.</p> Conclusion <p>Among adults with T2D and PAD, treatment with GLP-1RAs was associated with a lower risk of major limb events. There is a need of dedicated studies with standardized limb-specific endpoints to confirm the protective role of GLP-1RAs on limb events in people with T2D and PAD.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Glucagon-like peptide-1 receptor agonists and major limb events in adults with type 2 diabetes and peripheral artery disease: a systematic review and meta-analysis of RCTs and cohort studies

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月6日

查看全文
  • Paola Caruso,
  • Nicole Di Martino,
  • Miriam Longo,
  • Lorenzo Scappaticcio,
  • Giuseppe Bellastella,
  • Maria Ida Maiorino,
  • Katherine Esposito,
  • Dario Giugliano

摘要

Background

The impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on peripheral artery disease (PAD) remains uncertain. We assessed the association between GLP-1RA use and major limb events in individuals with type 2 diabetes (T2D) and PAD.

Methods

We performed a literature search from inception to 31 March 2026 for randomized controlled trials and cohort studies comparing GLP-1RA use versus placebo, active comparators or non-use on lower limb outcomes in individuals with T2D and PAD. The primary outcome was a composite of major limb events, as defined by the investigators of the original studies included in the meta-analysis. Secondary outcomes included lower extremity amputation (LEA), revascularization, gangrene, major adverse cardiovascular events (MACE) and all-cause mortality. Subgroup analyses, leave-one-out sensitivity analyses, and meta-regression analysis were also performed.

Results

Twelve studies (2 RCTs and 10 matched cohort studies) with thirteen arms involving 418,282 participants were included. Treatment with GLP-1RAs was associated with a significantly lower risk of major limb events by 27% (thirteen arms, RR 0.73, 95% CI 0.65–0.82). Reduced risks were also observed for LEA (RR 0.76, 95% CI 0.66–0.87), revascularization (RR 0.81, 95% CI 0.77–0.86), gangrene (RR 0.80, 95% CI 0.77–0.85), MACE (RR 0.76, 95% CI 0.63–0.90) and all-cause mortality (RR 0.67, 95% CI 0.61–0.73). Subgroup and sensitivity analyses did not substantially change point estimates.

Conclusion

Among adults with T2D and PAD, treatment with GLP-1RAs was associated with a lower risk of major limb events. There is a need of dedicated studies with standardized limb-specific endpoints to confirm the protective role of GLP-1RAs on limb events in people with T2D and PAD.

Graphical abstract