ReviewMeta-Analysis of Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Cardiovascular Outcomes and All-Cause Mortality Among Patients With Type 2 Diabetes Mellitus
Section snippets
Methods
This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions7 and was registered with international prospective register of systematic reviews (PROSPERO) (number, CRD42015026853).
An electronic search was performed in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) through January 27, 2016,
Results
A total of 1,268 citations were retrieved through electronic search, from which 172 potentially eligible reports were identified by reviewing study titles and abstracts. Finally, 37 eligible RCTs involving 28,859 patients were included in this meta-analysis (Figure 1). These patients were randomly assigned to a SGLT2 inhibitor (canagliflozin, dapagliflozin, or empagliflozin) or control groups (placebo or other active antidiabetic treatments). Sample sizes of individual trials ranged between 180
Discussion
Our network meta-analysis of all eligible RCTs involving 30,250 patients showed that none of the 3 SGLT2 inhibitors was harmful for CV outcomes or all-cause mortality. For the primary outcomes, only empagliflozin appeared associated with a lower risk of MACE and all-cause mortality compared to placebo, whereas neither dapagliflozin nor canagliflozin was significantly associated with any harm. With respect to secondary outcomes, only empagliflozin had lower risk of heart failure or heart failure
Disclosures
The authors have no conflicts of interest to disclose.
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Drs. Tang and Song were supported by the Indiana University Health–Indiana University School of Medicine Strategic Research Initiative.
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