The EXenatide Study of Cardiovascular Event Lowering (EXSCEL) was a randomized, placebo-controlled, global pragmatic clinical trial designed to assess the effect of subcutaneous once-weekly GLP-1 RA exenatide (EQW) 2 mg on cardiovascular outcomes in 14,752 participants with type 2 diabetes mellitus and a range of cardiovascular risk. The trial aimed to provide insight into the effects of open-label SGLT2i use in parallel with or shortly after once-weekly GLP-1 RA exenatide (EQW) on cardiorenal outcomes.
New Insights From This Study
Combination exenatide QW and SGLT2i caused significant reduction in cardiovascular death compared to exenatide alone or neither drug class.
All-cause mortality risk decreased with the combination, compared to exenatide alone or placebo.
SGLT2i-mediated eGFR slope improvement was consistent
Combination GLP-1 RA and SGLT2i may provide additional cardiovascular and mortality benefit to GLP-1 RA alone, without any increase in the risk of hypoglycemia.