PMID- 33293207
OWN - NLM
STAT- MEDLINE
DCOM- 20220112
LR  - 20221207
IS  - 1873-460X (Electronic)
IS  - 1056-8727 (Linking)
VI  - 35
IP  - 2
DP  - 2021 Feb
TI  - Comparison of the risk of SGLT2is and NonSGLT2is in leading to amputation: A 
      network meta-analysis.
PG  - 107803
LID - S1056-8727(20)30597-3 [pii]
LID - 10.1016/j.jdiacomp.2020.107803 [doi]
AB  - OBJECTIVE: Whether sodium-glucose cotransporter 2 inhibitors (SGLT2is) increase 
      the risk of amputation or not remains controversial. We aimed to evaluate the 
      relative risk of different SGLT2is and Non-SGLT2i antihyperglycemic drugs 
      (NonSGLT2is) in leading to amputation by network meta-analysis of large sample 
      studies. METHODS: We searched Embase and PubMed for relevant large sample 
      studies. We conducted Bayesian network meta-analysis using random-effects model. 
      Effect size was presented as hazard ratio (HR) and 95% confidence interval (CI). 
      RESULTS: Seventeen large studies involving 1 million SGLT2i users and 3 million 
      NonSGLT2i users were included in network meta-analysis. SGLT2is [HR (95% CI): 
      1.38 (1.02, 1.91)] versus NonSGLT2is significantly increased the amputation risk, 
      whereas SGLT2is [HR (95% CI): 1.45 (0.94, 2.17)] versus placebo did not. Compared 
      with glucagon-like peptide 1 receptor agonists (GLP1RAs), canagliflozin [HR (95% 
      CI): 1.5 (1.01, 2.33)] along with incorporative SGLT2is [HR (95% CI): 1.64 (1.07, 
      2.53)] significantly increased the amputation risk, whereas empagliflozin [HR 
      (95% CI): 1.46 (0.83, 2.67)] and dapagliflozin [HR (95% CI): 1.22 (0.7, 2.23)] 
      did not due to the wide 95% CIs of HRs. CONCLUSION: Although SGLT2is versus 
      placebo do not significantly increase the amputation risk, SGLT2is (especially, 
      canagliflozin) versus NonSGLT2is (especially, GLP1RAs) significantly increase 
      that risk.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Qiu, Mei
AU  - Qiu M
AD  - Department of General Medicine, Shenzhen Longhua District Central Hospital, 
      Shenzhen 518110, China.
FAU - Ding, Liang-Liang
AU  - Ding LL
AD  - Department of Endocrinology, First Affiliated Hospital of Yangtze University, 
      Jingzhou 434000, China.
FAU - Zhang, Miao
AU  - Zhang M
AD  - Department of Nephrology, Shenzhen Hospital of Beijing University of Chinese 
      Medicine, Shenzhen 518116, China.
FAU - Zhou, Hai-Rong
AU  - Zhou HR
AD  - Department of General Medicine, Shenzhen Longhua District Central Hospital, 
      Shenzhen 518110, China. Electronic address: 13798214835@sina.cn.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20201126
PL  - United States
TA  - J Diabetes Complications
JT  - Journal of diabetes and its complications
JID - 9204583
RN  - 0 (Benzhydryl Compounds)
RN  - 0 (GLP1R protein, human)
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Glucosides)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - 1ULL0QJ8UC (dapagliflozin)
RN  - HDC1R2M35U (empagliflozin)
SB  - IM
MH  - *Amputation, Surgical
MH  - Bayes Theorem
MH  - Benzhydryl Compounds
MH  - Canagliflozin/adverse effects
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology
MH  - Glucagon-Like Peptide-1 Receptor/agonists
MH  - Glucosides
MH  - Humans
MH  - Hypoglycemic Agents/*adverse effects/therapeutic use
MH  - Network Meta-Analysis
MH  - *Sodium-Glucose Transporter 2 Inhibitors/adverse effects
OTO - NOTNLM
OT  - Amputation
OT  - Canagliflozin
OT  - GLP1RAs
OT  - Network meta-analysis
OT  - SGLT2is
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2020/12/10 06:00
MHDA- 2022/01/13 06:00
CRDT- 2020/12/09 05:51
PHST- 2020/10/05 00:00 [received]
PHST- 2020/10/31 00:00 [revised]
PHST- 2020/11/06 00:00 [accepted]
PHST- 2020/12/10 06:00 [pubmed]
PHST- 2022/01/13 06:00 [medline]
PHST- 2020/12/09 05:51 [entrez]
AID - S1056-8727(20)30597-3 [pii]
AID - 10.1016/j.jdiacomp.2020.107803 [doi]
PST - ppublish
SO  - J Diabetes Complications. 2021 Feb;35(2):107803. doi: 
      10.1016/j.jdiacomp.2020.107803. Epub 2020 Nov 26.