Zerovnik S, Kos M, Locatelli I, et al. - When compared with dipeptidyl peptidase-4 inhibitors (DPP-4i) as an add-on therapy, sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) improved cardiovascular (CV) morbidity and mortality in individuals with type 2 diabetes (T2D). The findings of this study could be used to help clinicians choose the best add-on antidiabetic drug to reduce CV morbidity and death in patients with T2D.

• Between June 2014 and June 2018, patients with T2D who received newly introduced DPP-4i (n = 3,817), GLP-1RA (n = 855) or SGLT2i (n = 2,851) add-on therapy.

• When compared with DPP-4i, SGLT2i as an add-on therapy was linked with a lower risk of major adverse CV event (MACE) and CV mortality in the intention-to-treat analysis.

• On-treatment research demonstrated a decreased risk of heart failure (HF) in patients starting SGLT2i.

• GLP-1RA add-on therapy was related to a decreased MACE risk when compared with DPP-4i in the intention-to-treat analysis, but it had no effect on CV death or HF.

• The findings of on-treatment analyses agreed with the findings of intention-to-treat analyses.