Caturano Alfredo, D'Ardes Damiano, Simeone Paola Giustina, Lessiani Gianfranco, Gregorio Nicoletta Di, Andreetto Lorenzo, Grassi Davide, Serra Carla, Santilli Francesca, Guagnano Maria Teresa, Piscaglia Fabio, Ferri Claudio, Cipollone Francesco, Boccatonda Andrea
Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy.
Institute of "Clinica Medica", Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.
J Clin Med. 2025 Aug 6;14(15):5549. doi: 10.3390/jcm14155549.
Sodium-glucose co-transporter-2 inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP-1 RAs) are now established as cornerstone therapies for patients with type 2 diabetes mellitus (T2DM), given their cardiovascular and renal protective properties. However, their use in patients with peripheral artery disease (PAD) remains controversial due to concerns raised in early trials about potential increases in lower limb complications, particularly amputations. This narrative review examines current evidence on the association between SGLT2is and GLP-1 RAs in PAD-related outcomes, including limb events, amputation risk, and cardiovascular and renal endpoints. Drawing from randomized controlled trials, real-world cohort studies, and systematic reviews, we provide an integrated perspective on the safety and utility of SGLT2is and GLP-1 RAs in individuals with PAD, highlight patient selection considerations, and identify areas for future investigation.
鉴于钠-葡萄糖协同转运蛋白2抑制剂（SGLT2is）和胰高血糖素样肽-1受体激动剂（GLP-1 RAs）具有心血管和肾脏保护特性，它们现已成为2型糖尿病（T2DM）患者的基础治疗药物。然而，由于早期试验中对下肢并发症（尤其是截肢）潜在增加的担忧，它们在周围动脉疾病（PAD）患者中的使用仍存在争议。这篇叙述性综述探讨了目前关于SGLT2is和GLP-1 RAs与PAD相关结局（包括肢体事件、截肢风险以及心血管和肾脏终点）之间关联的证据。通过随机对照试验、真实世界队列研究和系统评价，我们对SGLT2is和GLP-1 RAs在PAD患者中的安全性和实用性提供了综合观点，强调了患者选择的考虑因素，并确定了未来的研究领域。
