GLP-1RA vs SGLT-2i

In the FIRE target trial emulation, both GLP-1RA and SGLT-2i arms showed monotonic one-year weight loss. GLP-1 receptor agonists and SGLT-2 inhibitors have randomized-trial evidence for cardiometabolic benefits in type 2 diabetes. The per-protocol difference was -0.98 kg, favoring GLP-1RA over SGLT-2i. Estimated one-year weight change was -4.02 kg for GLP-1RA and -3.04 kg for SGLT-2i. The estimated GLP-1RA versus SGLT-2i weight difference was close to SUSTAIN 8's semaglutide versus canagliflozin difference. Existing randomized trials are costly, selective, and usually evaluate specific agents rather than full drug classes in routine practice. The real-world result extends evidence from specific trial agents to full GLP-1RA and SGLT-2i classes in routine Swiss primary care.