Comparison of the effects of 10 GLP-1 RA and SGLT2 inhibitor interventions on cardiovascular,mortality, and kidney outcomes in type 2 diabetes: A network meta-analysis of large randomized trials |
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Authors: | Xu-Bin Wei Wei Wei Liang-Liang Ding Shu-Yan Liu |
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Institution: | 1. Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China;2. Department of Pharmacy, The Second Affiliated Hospital of Kunming Medical University, Kunming, China;3. Department of Cardiology, First Affiliated Hospital of Yangtze University, Jingzhou, China;4. Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China |
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Abstract: | The relative efficacy of different sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in reducing cardiorenal events in type 2 diabetic adults is unclear. We searched PubMed and Embase. Three primary endpoints were major adverse cardiovascular events (MACE), hospitalization for heart failure (HHF), and kidney function progression (KFP). Bayesian network meta-analysis was conducted to synthesize hazard ratio (HR) and 95% confidence interval (CI). We calculated surface under the cumulative ranking curve (SUCRA) to rank drug treatments. Subcutaneous semaglutide (HR 0.73, 95% CI 0.55?0.96) and albiglutide (HR 0.76, 95% CI 0.63?0.93) significantly reduced MACE versus lixisenatide. Canagliflozin (HRs: 0.69, 0.68, 0.67 and 0.58) and empagliflozin (HRs: 0.70, 0.69, 0.68 and 0.59) significantly reduced HHF versus dulaglutide, exenatide, lixisenatide and subcutaneous semaglutide. Dapagliflozin (HRs: 0.62, 0.60, 0.68 and 0.63) and empagliflozin (HRs: 0.64, 0.61, 0.69 and 0.64) significantly reduced KFP versus dulaglutide, exenatide, liraglutide and lixisenatide. Different drug treatments had the maximum SUCRA values as for preventing different cardiorenal endpoints. Different GLP-1 RAs and SGLT2 inhibitors have different efficacy in preventing cardiorenal endpoints in type 2 diabetes, and the most efficacious drugs are different as for preventing different cardiorenal endpoints. |
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Keywords: | Type 2 diabetes Cardiorenal events SGLT2 inhibitors GLP-1 RAs Network meta-analysis |
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