Comparative Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-Like Peptide-1 Receptor Agonists in Reducing Cardiovascular Events in Patients With Type 2 Diabetes.

One of the primary causes of death and morbidity among individuals with type 2 diabetes mellitus (T2DM) is stroke. Despite their well-established cardiovascular advantages, there is insufficient data to determine how well sodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) and glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs) prevent strokes. The research conducted a systematic review and performed a meta-analysis to assess the comparative effectiveness of SGLT2i versus GLP-1 RAs for preventing stroke incidents in T2DM patients. From 2020 to 2025, the study searched PubMed, Embase, and Web of Science following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Only observational, retrospective, and cohort studies comparing the outcomes of stroke by SGLT2i and GLP-1 RA were included in the study. For risk of bias assessment Newcastle Ottawa Scale (Version 2011) was used. For the meta-analysis, random effects methodology was used to analyze the hazard ratio (HR) with 95% CIs. The study used heterogeneity analysis in conjunction with sensitivity analyses. Eleven studies (with a total of over 500,000 participants) were included. The pooled HR for stroke was 0.92 (95% CI: 0.83-1.02), suggesting that SGLT2i and GLP-1 RA did not significantly differ from one another. Low to moderate heterogeneity was present (I = 27.4%). Sensitivity and subgroup analyses validated the findings' robustness. SGLT2i and GLP-1 RAs provided comparable protection against stroke in patients with T2DM. These findings will help clinicians in determining a suitable drug for T2DM patients against stroke.