SGLT2 inhibitors and GLP-1 receptor agonists have become guideline-endorsed cornerstones for treating the interconnected triad of cardiovascular disease, chronic kidney disease, and metabolic conditions.
Guideline-endorsedBoth SGLT2 inhibitors and GLP-1 receptor agonists are now widely recommended in clinical guidelines for their cardiovascular and kidney protective benefits in CKM syndrome.
What the researchers found
SGLT2 inhibitors and GLP-1 receptor agonists have strong, complementary evidence for cardiovascular and kidney protection in CKM syndrome and are now widely guideline-endorsed.
Why it matters
Heart disease, kidney disease, diabetes, and obesity frequently coexist and worsen each other. Having two proven drug classes that protect multiple organs simultaneously — rather than treating each condition in isolation — represents a paradigm shift in how these interconnected diseases are managed.
The numbers in context
Review covers the expansion of CKM treatments over the past decade, including evidence from major cardiovascular and renal outcome trials.
How the study worked
Narrative review comparing clinical trial evidence for established and emerging CKM syndrome therapies, with focus on SGLT2 inhibitors, GLP-1 RAs, and pipeline drug classes.
Who was studied
Patients with cardiovascular-kidney-metabolic syndrome across reviewed clinical trials
What this study cannot tell us
As a narrative review, this does not include new primary data or systematic methodology. Real-world prescribing patterns often lag behind guideline recommendations. The review acknowledges that the growing complexity of available therapies makes clinical decision-making increasingly challenging.
How to read the evidence
This is a narrative review synthesizing evidence from multiple large randomized controlled trials. The underlying evidence is strong, though the review itself does not generate new data.
When this study was published
Published in 2025, reflecting the most current guideline recommendations and pipeline therapies.
The bigger picture
The concept of CKM syndrome reflects a shift from siloed treatment of individual diseases to integrated management of interconnected metabolic and organ damage. GLP-1 receptor agonists and SGLT2 inhibitors are at the center of this shift, with dual and triple agonists in the pipeline promising even broader protection.
Questions still open
- Should GLP-1 agonists and SGLT2 inhibitors be routinely combined for CKM patients, and in what order?
- Will emerging dual GLP-1/GIP agonists like tirzepatide further improve cardiovascular and renal outcomes?
- How can real-world prescribing better reflect the strong evidence supporting these therapies?
Common questions
What is CKM syndrome?
Can GLP-1 drugs and SGLT2 inhibitors be taken together?
Read the original research
Established and Emerging Therapies for Cardiovascular-Kidney-Metabolic Syndrome: Harnessing the Benefits of SGLT-2 Inhibitors, GLP-1 Receptor Agonists, and Beyond.
Heart, lung & circulation, 34(10), 995-1005
Citation
Allahwala, Momina A; Marathe, Chinmay S; Nelson, Adam J; Psaltis, Peter J; Marathe, Jessica A. (2025). Established and Emerging Therapies for Cardiovascular-Kidney-Metabolic Syndrome: Harnessing the Benefits of SGLT-2 Inhibitors, GLP-1 Receptor Agonists, and Beyond.. Heart, lung & circulation, 34(10), 995-1005. https://doi.org/10.1016/j.hlc.2025.07.005