PMID- 36589800
OWN - NLM
STAT- MEDLINE
DCOM- 20230103
LR  - 20230127
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 13
DP  - 2022
TI  - Comparison the effects of finerenone and SGLT2i on cardiovascular and renal 
      outcomes in patients with type 2 diabetes mellitus: A network meta-analysis.
PG  - 1078686
LID - 10.3389/fendo.2022.1078686 [doi]
LID - 1078686
AB  - BACKGROUND: Finerenone and sodium-glucose cotransporter 2 inhibitors (SGLT2i) 
      have been shown to improve cardiovascular and renal outcomes in patients with 
      type 2 diabetes mellitus (T2DM), while the relative efficacy has not been 
      determined. METHODS: The databases of PubMed, Embase and Cochrane were searched 
      for relevant cardiovascular or renal outcome trials of SGLT2i or finerenone. The 
      end points were major adverse cardiovascular events (MACE), nonfatal stroke (NS), 
      myocardial infarction (MI), hospitalization for heart failure (HHF), 
      cardiovascular death (CVD), and renal composite outcome (RCO). Network 
      meta-analysis was performed using Bayesian networks to obtain pooled hazard 
      ratios (HR) and 95% confidence intervals (CI). The probability values for ranking 
      active and placebo interventions were calculated using cumulative ranking curves. 
      RESULTS: 1024 articles were searched, and only 9 studies were screened and 
      included in this meta-analysis with 71793 randomized participants. Sotagliflozin 
      (HR 0.72 95%CI 0.59-0.88, SUCAR=0.93) and canagliflozin (HR 0.80 95%CI 0.67-0.97, 
      SUCAR=0.73) can significantly reduce the risk of MACE compared with placebo. 
      Canagliflozin (HR 0.64 95%CI 0.48-0.86, SUCAR=0.73), sotagliflozin (HR 0.66 95%CI 
      0.50-0.87, SUCAR=0.69) and empagliflozin (HR 0.65 95%CI 0.43-0.98, SUCAR=0.68) 
      can significantly reduce the risk of HHF compared with placebo. Empagliflozin (HR 
      0.62 95%CI 0.43-0.89, SUCAR=0.96) can significantly reduce the risk of CVD 
      compared with placebo. Empagliflozin (HR 0.61 95%CI 0.39-0.96, SUCAR=0.74), 
      canagliflozin (HR 0.66 95%CI 0.46-0.92, SUCAR=0.63), and dapagliflozin (HR 0.53 
      95%CI 0.32-0.85, SUCAR=0.88) can significantly reduce the risk of RCO compared 
      with placebo. Finerenone has reduced the risk of MACE, MI, HHF, CVD and RCO to 
      varying degrees, but they do not show significant difference from placebo and 
      each SGLT2i. CONCLUSION: Both SGLT2i and finerenone could reduce the risk of 
      MACE, HHF, MI, CVD, RCO. Finerenone has no obvious advantage than SGLT2i on the 
      effects of cardiovascular and renal protective. SYSTEMATIC REVIEW REGISTRATION: 
      https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022375092.
CI  - Copyright (c) 2022 Li, Wu, Peng and Jiang.
FAU - Li, Xuefeng
AU  - Li X
AD  - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of 
      Henan University of Science and Technology, Luoyang, China.
FAU - Wu, Hongli
AU  - Wu H
AD  - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of 
      Henan University of Science and Technology, Luoyang, China.
FAU - Peng, Huifang
AU  - Peng H
AD  - Endocrinology and Metabolism Center, The First Affiliated Hospital, and College 
      of Clinical Medicine of Henan University of Science and Technology; Henan Key 
      Laboratory of Rare Diseases, Luoyang, China.
FAU - Jiang, Hongwei
AU  - Jiang H
AD  - Endocrinology and Metabolism Center, The First Affiliated Hospital, and College 
      of Clinical Medicine of Henan University of Science and Technology; Henan Key 
      Laboratory of Rare Diseases, Luoyang, China.
LA  - eng
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20221215
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - HDC1R2M35U (empagliflozin)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - 0 (finerenone)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/chemically induced
MH  - Canagliflozin/therapeutic use
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
MH  - Network Meta-Analysis
MH  - Bayes Theorem
MH  - Risk Factors
MH  - Treatment Outcome
MH  - *Heart Failure/drug therapy
MH  - *Myocardial Infarction
PMC - PMC9797657
OTO - NOTNLM
OT  - SGLT2i
OT  - T2DM
OT  - cardiovascular and renal outcomes
OT  - finerenone (BAY 94-8862)
OT  - network meta-analysis
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- 2023/01/03 06:00
MHDA- 2023/01/04 06:00
PMCR- 2022/01/01
CRDT- 2023/01/02 04:08
PHST- 2022/10/24 00:00 [received]
PHST- 2022/12/01 00:00 [accepted]
PHST- 2023/01/02 04:08 [entrez]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/01/04 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2022.1078686 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2022 Dec 15;13:1078686. doi: 
      10.3389/fendo.2022.1078686. eCollection 2022.