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Publications

Journal Article Review Epublish

PubMed: 40807170 DOI: 10.3390/jcm14155549

SGLT2 Inhibitors and GLP-1 Receptor Agonists in PAD: A State-of-the-Art Review.

J Clin Med 14(15)

Authors: Alfredo Caturano, Damiano D'Ardes, Paola Giustina Simeone, Gianfranco Lessiani, Nicoletta Di Gregorio, Lorenzo Andreetto, Davide Grassi, Carla Serra, Francesca Santilli, Maria Teresa Guagnano, Fabio Piscaglia, Claudio Ferri, Francesco Cipollone, Andrea Boccatonda

Affiliations

  • 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.
  • Angiology Unit, Internal Medicine Department, Città S. Angelo Hospital, Città S. Angelo, 65013 Pescara, Italy.
  • Department of Life, Health & Environmental Sciences and Internal Medicine, ASL Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
  • Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, 40138 Bologna, Italy.
  • Internal Medicine Unit, Val Vibrata Hospital-Sant'Omero (TE), Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
  • Diagnostic and Therapeutic Interventional Ultrasound Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
  • Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.
  • Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.

Abstract

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.

MeSH

Diabetes Mellitus, Glucagon-Like Peptide 1, Sodium-Glucose Transporter 2 Inhibitors, Glucagon-Like Peptide-1 Receptor, Amputation, Surgical, Diabetes Mellitus, Type 2