ArticleEndocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists2026
Comparative Weight-Loss Outcomes Following Initiation of GLP-1 Receptor Agonists Versus SGLT2 Inhibitors: A Real-World Active Comparator Study.
Article in Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare 12-month weight loss between glucagon-like peptide 1 receptor agonist (GLP-1RA) and SGLT2 inhibitor (SGLT2i) initiators and assess effect modification by diabetes status, sex, and race/ethnicity in a diverse US cohort.
methodsRetrospective active comparator new-user cohort study using the NIH All of Us Research Program (2018-2023). We identified 2932 SGLT2i-naïve GLP-1RA initiators and 941 GLP-1RA-naïve SGLT2i initiators aged 18 to 80 with body mass index ≥27 kg/m
resultsAfter inverse probability of treatment weighting, GLP-1RA initiators lost more weight than SGLT2i initiators (difference -1.20 pp [95% confidence interval [CI], -1.91 to -0.48]; P =.001; odds ratio 1.75 [95% CI, 1.40-2.19]; risk ratio 1.61 [95% CI, 1.19-2.03]; number needed to treat 14), concentrated in obesity-only patients (-1.96 pp; P < .001) but absent in type 2 diabetes (+0.08 pp; interaction P =.006). Sex modified the effect (P =.017): -1.71 pp in women vs +0.12 pp in men. HbA1c decreased more with GLP-1RA (-0.261%; P =.032); blood pressure did not differ significantly.
conclusionGLP-1RA initiators achieved greater weight loss than SGLT2i initiators, concentrated in women and patients without type 2 diabetes, supporting individualized treatment selection. Interaction findings are hypothesis-generating and require prospective confirmation.
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