In patients with type 2 diabetes mellitus (T2DM), sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used to reduce cardiovascular risk, but whether outcomes differ across individual agents remains unclear. A systematic review and network meta-analysis published in Diabetes Research and Clinical Practice compared cardiovascular outcomes with bexagliflozin, ertugliflozin, and sotagliflozin.

The analysis included phase 3 or higher randomized controlled trials identified from ClinicalTrials.gov, PubMed, Cochrane CENTRAL, and Embase. The primary endpoint was a composite of cardiovascular death or hospitalization for heart failure (HF), with secondary endpoints including cardiovascular death, HF hospitalization, and all-cause mortality.

Compared with placebo, pooled estimates showed lower odds of composite cardiovascular death or HF hospitalization (OR 0.66; 95% CI 0.48–0.89), HF hospitalization (OR 0.62; 95% CI 0.55-0.70), and acute coronary syndrome events (OR 0.35; 95% CI 0.16-0.77). Lower odds of myocardial infarction were observed with bexagliflozin (OR 0.39; 95% CI 0.16-0.94) and sotagliflozin (OR 0.41; 95% CI 0.23-0.72) compared with ertugliflozin.

No significant differences were observed across agents for primary and most secondary outcomes. Overall, the findings indicate consistent cardiovascular effects across these agents, with variation noted for myocardial infarction.