Early Add-On Combination of GLP-1 Receptor Agonist and SGLT2 Inhibitor in People With Cardiovascular-Kidney-Metabolic Stage 2-3

This retrospective observational target-trial emulation uses electronic health record data from the TriNetX US Collaborative Network to compare early treatment intensification strategies in adults with obesity, type 2 diabetes, and cardiovascular-kidney-metabolic stage 2-3 who initiate a GLP-1 receptor agonist or an SGLT2 inhibitor. The study compares patients who, within 90 days of starting background therapy, add the alternate agent, add a DPP-4 inhibitor or sulfonylurea, or do not receive early add-on therapy. The primary outcome is all-cause mortality over 36 months, with secondary cardiorenal outcomes also evaluated. Propensity-score methods are used to reduce bias from nonrandom treatment selection.

NCT Number	NCT07465926
Lead Sponsor	Chung Shan Medical University Collaborators: National Science and Technology Council, Taiwan
Conditions	Cardiovascular-kidney-metabolic Syndrome, Cardiovascular Disease Risk Factor, Kidney Disease, Type 2 Diabetes, Obesity & Overweight
Enrollment	451,036 participants
Start Date	2017-01-01
Primary Completion	2026-01-31 (estimated)
Study Completion	2026-01-31 (estimated)
Updated on ClinicalTrials.gov	2026-06-22