时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
The central objective of this review is to assess the extent to which older patients were included in the pivotal trials of GLP1-based therapies and SGLT2-I.；Particularly, the questions related to beneficial or deleterious body composition changes and related health risks such as falls and fractures in older patients may be hidden in trial reports we have not considered due to the fact that they were not relevant for the European approval process.It is important to emphasize that the central objective of this review was to assess the extent to which older patients were included in the pivotal trials of GLP1-based therapies and SGLT2-I.
方法
Whereas some evidence concerning efficacy has been reported previously (Karagiannis et al., 2021), adverse drug reactions (ADR) associated with the use of both drug classes in older patients are clearly underreported in the literature, although they are at particular risk to experience typical ADR associated with both drug classes.；In Figure 1, we summarize the best described modes of action and clinical effects of GLP1-RA and SGLT2-I, and also well-known ADRs associated with their use which are mostly easily to explain by their modes of action.；Delaying gastric emptying in old patients might interact with the adherence to oral drug prescriptions (which are typically many in old age) but also might influence eating habits in a manner leading to malnutrition (Tzakri et al., 2024).
核心结论
Besides glycemic control and weight reduction, clinical trials demonstrated a reduction of major adverse cardiovascular events (MACE), as well as improvements of systolic blood pressure and plasma lipid profile, and also anti-inflammatory effects, not the least on the level of the endothelium.The inhibition of renal sodium-glucose cotransporter 2 (SGLT2) leads to a reduction of tubular glucose and sodium reabsorption with increased urinary excretion of glucose and osmotic diuresis resulting in increased tubuloglomerular feedback and diminished intraglomerular pressure (Parveen et al., 2025).；Overall, we included n = 185 sources related to the 106 trials.；Taken together, the trial populations of the AWARD 1-5 trials included 18.5% (n = 847) patients aged ≥65 years and 1.9% (n = 86) aged ≥75 years (European Medicines Agency, 2014b).
局限
Sometimes however, a different categorization was used which we also reported.3Results3.1Selection processThis review is based on the analysis of n = 28 EPAR and n = 9 SmPC of the active compounds liraglutide, dulaglutide, semaglutide, tirzepatide, dapagliflozin and empagliflozin (Figure 2; Supplementary Tables S1, S2).；However, the proportion of patients ≥75 years, which was additionally published for some trials, was only 0.2%–3.5% and the highest absolute number in a trial was n = 55 patients.；For all groups, semaglutide tended to have an advantage compared to placebo; however, this was only significant in the 55 to <65 years and 65 to <75 years groups, with the smallest trend and greatest variability in the ≥75-year-olds.
对本项目的价值
中等价值：属「血管 / 心血管老化」方向；血管 / 心血管老化栏目可用作本项目文献库与综述素材。 ｜ 价值分 2.7/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 71,508 字符，题名指纹 1.0，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：GLP-1 受体激动剂与 SGLT2 抑制剂年龄分层证据的可及性：欧洲公共评估报告分析（聚焦老年患者）
- 英文标题：Availability of age-stratified evidence for GLP1 receptor agonists and SGLT2 inhibitors: an analysis of European public assessment reports with a focus on older patients.
- 期刊与标识：Frontiers in pharmacology · PMID 42978648 · DOI 10.3389/fphar.2026.1786211 · PMC PMC13727555