Outcome-Stratified Positioning of Incretin Therapies Across Cardiometabolic Phenotypes

This narrative review gives endocrinology and obesity pharmacists a framework that separates hard cardiovascular and renal outcome evidence from surrogate and mechanistic signals when positioning GLP-1 receptor agonists and next-generation polyagonists.

📅 Journal publication: Sep 1, 2026 · Last updated: Oct 7, 2026

GLP-1 receptor agonistssemaglutidetirzepatideretatrutidecagrilintideorforgliprondanuglipronincretin therapypolyagonismtype 2 diabetesobesitychronic kidney diseasecardiovascular outcomesMASLDnarrative reviewcardiometabolic Endocrinology / Diabetes / Obesity

Also in Nephrology

Background Information

Incretin therapies expand treatment options for cardiometabolic conditions.

Incretin-based therapies have roles beyond glucose control, including cardiovascular and renal benefits, impacting treatment strategies in diabetes and obesity. GLP-1 receptor agonists show cardiovascular and kidney benefits, while newer polyagonists primarily affect glucose and weight metrics. Evidence supports prioritizing GLP-1 receptor agonists for cardiovascular risk in diabetes and semaglutide for kidney disease, highlighting phenotype-driven therapy choices. Incretin therapies offer diverse benefits; use should reflect specific patient characteristics and outcomes.

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Authors: Sztanek F, Lőrincz H, Harangi M, Nagy AC

Citation: Sztanek F, Lőrincz H, Harangi M, et al. Incretin-Based Therapies as Cardiometabolic Interventions: Outcome Hierarchy, Receptor-Network Pharmacology and Phenotype-Based Clinical Positioning. Diabetes, obesity & metabolism. 2026. doi:10.1111/dom.71277

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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