Background/Objectives: Sodium–glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown blood pressure (BP) reduction in type 2 diabetes (T2D). However, head-to-head comparisons in hypertensive patients remain limited. This study assessed the effects of SGLT2i and GLP-1RA on systolic BP (SBP), diastolic BP (DBP), antihypertensive regimen modifications, and adverse events in Saudi patients with both conditions. Methods: A retrospective cohort study was conducted between January 2022 and April 2024 using records from two hospitals. Adults with T2D and hypertension who initiated SGLT2i or GLP-1RA and had ≥2 BP readings were included. BP changes were analyzed with ANOVA; adverse events and treatment discontinuation were assessed with Chi-square and Kaplan–Meier analysis. Results: Of 505 patients, 291 (57.6%) received SGLT2i and 214 received GLP-1RA. Both classes significantly reduced SBP (p < 0.001), and DBP decreased significantly only in the SGLT2i group (p < 0.001). Antihypertensive regimen reduction occurred in 6.9% of patients, most commonly among SGLT2i users (74.3%), while 76.8% remained on the same regimen; the remaining patients had other modifications such as dosage adjustments or changes in individual agents. Adverse events occurred in 6.3% of patients with no group differences. Therapy discontinuation was higher with GLP-1RA (12.6%) versus SGLT2i (2.4%, p < 0.001). Conclusions: Both SGLT2i and GLP-1RA might be considered in patients with T2D and hypertension, with SGLT2i potentially offering additional benefits for DBP reduction and simplifying antihypertensive regimens, which could support clinical decision-making in real-world practice.

Background: Foodborne botulism is a rare but potentially fatal neuroparalytic illness caused by ingestion of Clostridium botulinum neurotoxins. Current treatment strategies include antitoxin administration, supportive care, and adjunctive therapies such as guanidine and 3,4-diaminopyridine. However, evidence comparing the efficacy of these interventions remain limited and inconclusive. This systematic review and meta-analysis aimed to evaluate treatment outcomes and compare the effectiveness of antitoxin, supportive care, and adjunctive therapies in managing foodborne botulism. Methods: A systematic search of PubMed and Web of Science was performed, and relevant studies were screened using predefined criteria. Data extraction and quality assessment were conducted independently by two reviewers. Pooled treatment success rates were calculated using random-effects meta-analysis with heterogeneity assessed via I² statistics. Results: 38 studies met our inclusion criteria, including case reports, case series, and observational studies. Pooled treatment success rates were high for antitoxin (95.3%, 95% CI: 91.3–97.8; p<0.001, I²=16.4%), supportive care (97.6%, 95% CI: 91.9–99.3; p<0.001, I²=0%), and guanidine (88.9%, 95% CI: 46.3–97.1; p<0.001, I²=0%). Comparative analyses showed no statistically significant differences between antitoxin alone versus combination therapy (OR 0.92, 95% CI: 0.10–8.62; p=0.94, I²=0%) or versus supportive care (OR 2.19, 95% CI: 0.28–17.14; p=0.46, I²=0%). Guanidine showed potential benefit as an adjunct, but data were limited. Conclusions: Antitoxin remains standard care for foodborne botulism, though supportive care and adjunctive treatments also show favorable outcomes. Further multicenter studies with standardized protocols are needed to optimize management.