PMID- 34780865 OWN - NLM STAT- MEDLINE DCOM- 20220208 LR - 20220208 IS - 1872-8227 (Electronic) IS - 0168-8227 (Linking) VI - 183 DP - 2022 Jan TI - Comparison of effects of SGLT-2 inhibitors and GLP-1 receptor agonists on cardiovascular and renal outcomes in type 2 diabetes mellitus patients with/without albuminuria: A systematic review and network meta-analysis. PG - 109146 LID - S0168-8227(21)00506-4 [pii] LID - 10.1016/j.diabres.2021.109146 [doi] AB - AIMS: It remains unclear which sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are most effective for preventing cardiovascular and renal events in type 2 diabetes mellitus (T2DM) patients, depending on the presence of albuminuria. We conducted a network meta-analysis to compare the efficacy of these two drug classes in T2DM patients with/without albuminuria. METHODS: We searched the Medline, EMBASE, Cochrane Library databases, and gray literature up to April 20, 2021. We included randomized controlled trials that reported the risk of major adverse cardiovascular events (MACE) and composite of renal outcomes in T2DM. RESULTS: A total of nine studies (81,206 patients) were included. In patients with/without albuminuria, SGLT-2 inhibitors did not significantly reduce the risk of MACE compared with GLP-1 RAs (risk ratio [RR] [95% confidence interval]; 0.96 [0.82-1.12] and 0.94 [0.81-1.10], respectively). In contrast, compared with GLP-1 RAs, SGLT-2 inhibitors were associated with significantly lower renal risk in both patients with/without albuminuria (RR [95% CI]; 0.75 [0.63-0.89] and 0.59 [0.44-0.79], respectively). CONCLUSIONS: SGLT-2 inhibitors may be superior to GLP-1 RAs for renal outcomes in T2DM patients with/without albuminuria, although there was no difference in the risk of MACE. CI - Copyright (c) 2021 Elsevier B.V. All rights reserved. FAU - Kawai, Yuki AU - Kawai Y AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. FAU - Uneda, Kazushi AU - Uneda K AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University School of Medicine, 21-2 Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu 969-3492, Japan. FAU - Yamada, Takayuki AU - Yamada T AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Kinguchi, Sho AU - Kinguchi S AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. Electronic address: kinguchi@yokohama-cu.ac.jp. FAU - Kobayashi, Kazuo AU - Kobayashi K AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; Committee of Hypertension and Kidney Disease, Kanagawa Physicians Association, Yokohama, Japan. FAU - Azushima, Kengo AU - Azushima K AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. FAU - Kanaoka, Tomohiko AU - Kanaoka T AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. FAU - Toya, Yoshiyuki AU - Toya Y AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. FAU - Wakui, Hiromichi AU - Wakui H AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. Electronic address: hiro1234@yokohama-cu.ac.jp. FAU - Tamura, Kouichi AU - Tamura K AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20211112 PL - Ireland TA - Diabetes Res Clin Pract JT - Diabetes research and clinical practice JID - 8508335 RN - 0 (Glucagon-Like Peptide-1 Receptor) RN - 0 (Hypoglycemic Agents) RN - 0 (Pharmaceutical Preparations) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - Albuminuria/drug therapy MH - *Cardiovascular Diseases/epidemiology/etiology/prevention & control MH - *Diabetes Mellitus, Type 2/complications/drug therapy MH - Glucagon-Like Peptide-1 Receptor MH - Humans MH - Hypoglycemic Agents/therapeutic use MH - Network Meta-Analysis MH - *Pharmaceutical Preparations MH - *Sodium-Glucose Transporter 2 Inhibitors OTO - NOTNLM OT - Albuminuria OT - Cardiovascular disease OT - Diabetes mellitus OT - GLP-1 receptor agonists OT - Renal outcomes OT - SGLT-2 inhibitors 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- 2021/11/16 06:00 MHDA- 2022/02/09 06:00 CRDT- 2021/11/15 20:13 PHST- 2021/02/16 00:00 [received] PHST- 2021/08/31 00:00 [revised] PHST- 2021/11/09 00:00 [accepted] PHST- 2021/11/16 06:00 [pubmed] PHST- 2022/02/09 06:00 [medline] PHST- 2021/11/15 20:13 [entrez] AID - S0168-8227(21)00506-4 [pii] AID - 10.1016/j.diabres.2021.109146 [doi] PST - ppublish SO - Diabetes Res Clin Pract. 2022 Jan;183:109146. doi: 10.1016/j.diabres.2021.109146. Epub 2021 Nov 12.