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Sodium-glucose co-transporter-2 inhibition and ocular outcomes in patients with type 2 diabetes: A systematic review and meta-analysis |
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| Authors: | Chao Li MD Zien Zhou MD Brendon L Neuen MBBS Jie Yu MD Yuli Huang PhD Tamara Young MBBS Jingwei Li PhD Lin Li MD Vlado Perkovic PhD Meg J Jardine PhD Lisa Keay PhD Maria Markoulli PhD Norm Rosenthal PhD George Capuano PhD Yshai Yavin PhD Bruce Neal PhD Clare Arnott PhD |
| Institution: | 1. Cardiovascular Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China;2. George Institute for Global Health, UNSW Sydney, Sydney, Australia
Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;3. George Institute for Global Health, UNSW Sydney, Sydney, Australia;4. George Institute for Global Health, UNSW Sydney, Sydney, Australia Department of Cardiology, People's Liberation Army General Hospital, Beijing, China Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, China;5. Beijing Tongren Eye Centre, Beijing Tongren Hospital, Beijing, China Beijing Ophthalmology and Visual Sciences Key Laboratory, Capital Medical University, Beijing, China;6. George Institute for Global Health, UNSW Sydney, Sydney, Australia UNSW, Sydney, Australia The Royal North Shore Hospital, Sydney, Australia;7. George Institute for Global Health, UNSW Sydney, Sydney, Australia UNSW, Sydney, Australia Concord Repatriation General Hospital, Sydney, Australia;8. George Institute for Global Health, UNSW Sydney, Sydney, Australia School of Optometry and Vision Science, UNSW, Sydney, Australia;9. School of Optometry and Vision Science, UNSW, Sydney, Australia;10. Janssen Research & Development, LLC, Raritan, New Jersey |
| Abstract: | Sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective for the treatment of macrovascular complications and nephropathy in type 2 diabetes, but effects on microvascular eye outcomes are unclear. We conducted a systematic review and meta-analysis of randomized placebo-controlled trials to evaluate the effect of SGLT2 inhibition on total ocular events and retinopathy in patients with type 2 diabetes. We searched MEDLINE and Embase for the period from database inception date to October 11, 2019. Two reviewers working independently extracted relevant data. Random-effects models with inverse variance weighting were selected to estimate summary risk ratios (RRs) and 95% confidence intervals (CIs). We included nine studies, involving 39 982 patients with a mean follow-up of 2.8 years. There were 1414 total ocular events, of which 624 were retinopathy events. SGLT2 inhibition was not associated with a change in the risk of total ocular events (RR 0.97, 95% CI 0.85, 1.11) or retinopathy (RR 0.98, 95% CI 0.84, 1.16), with consistent effects across studies (P for heterogeneity = 0.35 and 0.45, respectively). The effects of SGLT2 inhibition on eye disease in individuals with type 2 diabetes are probably null, although the available data cannot exclude small to moderate benefits or harms. |
| Keywords: | SGLT2 inhibitor diabetic retinopathy meta-analysis systematic review randomized trial type 2 diabetes |