PMID- 35370961
OWN - NLM
STAT- MEDLINE
DCOM- 20220405
LR  - 20220519
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 13
DP  - 2022
TI  - Comparative Cardiovascular Outcomes of SGLT2 Inhibitors in Type 2 Diabetes 
      Mellitus: A Network Meta-Analysis of Randomized Controlled Trials.
PG  - 802992
LID - 10.3389/fendo.2022.802992 [doi]
LID - 802992
AB  - BACKGROUND: A network meta-analysis of randomized controlled trials (RCTs) was 
      conducted to explore the cardiovascular outcomes of all the kind and dosages of 
      sodium-glucose cotransport-2 (SGLT2) inhibitors in type 2 diabetes mellitus 
      (T2DM) patients. METHOD AND RESULT: The Cochrane Library, PubMed, and Embase 
      databases were systematically searched for studies to compare the therapeutic 
      effects of different SGLT2 inhibitors in T2DM patients. The effect measurements 
      estimate chosen were odds ratios (ORs) and their corresponding 95% confidence 
      interval (CI). Forty-seven RCTs involving a total of 70574 participants were 
      eligible for direct and indirect comparisons. In direct comparison, treatment 
      with dapagliflozin 5mg showed significantly lower risk of all-cause mortality 
      compared with treatment with dapagliflozin 2.5mg (OR 0.09, 95% CI 0.01-0.70). 
      According to NMA, interestingly, empagliflozin 10mg/25mg, and canagliflozin 100mg 
      was associated with significantly lower risks of all-cause mortality compared 
      with placebo (OR of 0.70, 95% CI 0.58-0.85; 0.69, 95% CI 0.57-0.84; and 0.83, 95% 
      CI 0.73-0.95, respectively). Compared with placebo, dapagliflozin 10mg, 
      empagliflozin 10mg and 25mg displayed the lower risks for cardiovascular events 
      (OR 0.78, 95% CI 0.44-1.00; OR 0.47, 95% CI 0.22-0.93; and 0.43, 95% CI 
      0.24-0.74, respectively) by direct comparison. Moreover, canagliflozin 100/300mg 
      showed significantly higher risks of cardiovascular events compared with 
      empagliflozin 10mg (OR of 4.83, 95% CI 1.14-20.46 and 5.31, 95% CI 1.26-22.34, 
      respectively) and empagliflozin 25mg (4.23, 95% CI 1.13-15.83 and 4.65, 95% CI 
      1.25-17.27, respectively) according to NMA. There were non-significant 
      differences among all interventions in volume depletion in traditional pairwise 
      meta-analysis. While in NMA, canagliflozin 100/300mg were associated with 
      significantly increased risks of volume depletion compared with placebo (OR of 
      1.47, 95% CI 1.08-1.99 and 2.19, 95% CI 1.66-2.90, respectively). CONCLUSION: In 
      the limitations of the NMA, this study showed that empagliflozin might be better 
      than other SGLT2 inhibitors with low risks of all-cause mortality and 
      cardiovascular events in patients with T2DM suggesting the need for ad hoc RCTs.
CI  - Copyright (c) 2022 Jiang, Yang, Fu, Sun, Shen and Wu.
FAU - Jiang, Yu
AU  - Jiang Y
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
AD  - Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Yang, Pingping
AU  - Yang P
AD  - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of 
      Nanchang University, Nanchang, China.
FAU - Fu, Linghua
AU  - Fu L
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Sun, Lizhe
AU  - Sun L
AD  - Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an 
      Jiaotong University, Xi'an, China.
FAU - Shen, Wen
AU  - Shen W
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Wu, Qinghua
AU  - Wu Q
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220316
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
SB  - IM
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
PMC - PMC8967154
OTO - NOTNLM
OT  - SGLT2 inhibitors
OT  - cardiovascular events
OT  - empagliflozin
OT  - meta-analysis
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/04/05 06:00
MHDA- 2022/04/06 06:00
PMCR- 2022/01/01
CRDT- 2022/04/04 05:28
PHST- 2021/10/27 00:00 [received]
PHST- 2022/01/13 00:00 [accepted]
PHST- 2022/04/04 05:28 [entrez]
PHST- 2022/04/05 06:00 [pubmed]
PHST- 2022/04/06 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2022.802992 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2022 Mar 16;13:802992. doi: 
      10.3389/fendo.2022.802992. eCollection 2022.