دورية أكاديمية
The longer-term benefits and harms of glucagon-like peptide-1 receptor agonists: a systematic review and meta-analysis
| العنوان: | The longer-term benefits and harms of glucagon-like peptide-1 receptor agonists: a systematic review and meta-analysis |
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| المؤلفون: | Alexander, JT, Staab, EM, Wan, W, Franco, M, Knitter, A, Skandari, MR, Bolen, S, Maruthur, NM, Huang, ES, Philipson, LH, Winn, AN, Thomas, CC, Zeytinoglu, M, Press, VG, Tung, EL, Gunter, K, Bindon, B, Jumani, S, Laiteerapong, N |
| المصدر: | 438 ; 415 |
| بيانات النشر: | Springer Science and Business Media LLC |
| سنة النشر: | 2021 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Health Care Sciences & Services, Medicine, General & Internal, General & Internal Medicine, meta-analysis, systematic review, diabetes, glucagon-like peptide 1 receptor agonists, CARDIOVASCULAR OUTCOMES, BASAL INSULIN, TYPE-2, MANAGEMENT, THERAPY, glucagon-like peptide-1 receptor agonists, 1103 Clinical Sciences |
| الوصف: | Background Previous meta-analyses of the benefits and harms of glucagon-like peptide-1 receptor agonists (GLP1RAs) have been limited to specific outcomes and comparisons and often included short-term results. We aimed to estimate the longer-term effects of GLP1RAs on cardiovascular risk factors, microvascular and macrovascular complications, mortality, and adverse events in patients with type 2 diabetes, compared to placebo and other anti-hyperglycemic medications. Methods We searched PubMed, Scopus, and clinicaltrials.gov (inception–July 2019) for randomized controlled trials ≥ 52 weeks’ duration that compared a GLP1RA to placebo or other anti-hyperglycemic medication and included at least one outcome of interest. Outcomes included cardiovascular risk factors, microvascular and macrovascular complications, all-cause mortality, and treatment-related adverse events. We performed random effects meta-analyses to give summary estimates using weighted mean differences (MD) and pooled relative risks (RR). Risk of bias was assessed using the Cochrane Collaboration risk of bias in randomized trials tool. Quality of evidence was summarized using the Grading of Recommendations, Assessment, Development, and Evaluation approach. The study was registered a priori with PROSPERO (CRD42018090506). Results Forty-five trials with a mean duration of 1.7 years comprising 71,517 patients were included. Compared to placebo, GLP1RAs reduced cardiovascular risk factors, microvascular complications (including renal events, RR 0.85, 0.80–0.90), macrovascular complications (including stroke, RR 0.86, 0.78–0.95), and mortality (RR 0.89, 0.84–0.94). Compared to other anti-hyperglycemic medications, GLP1RAs only reduced cardiovascular risk factors. Increased gastrointestinal events causing treatment discontinuation were observed in both comparisons. Discussion GLP1RAs reduced cardiovascular risk factors and increased gastrointestinal events compared to placebo and other anti-hyperglycemic medications. GLP1RAs also reduced MACE, stroke, renal ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0884-8734 |
| العلاقة: | Journal of General Internal Medicine; http://hdl.handle.net/10044/1/91768Test |
| DOI: | 10.1007/s11606-021-07105-9 |
| الإتاحة: | https://doi.org/10.1007/s11606-021-07105-9Test http://hdl.handle.net/10044/1/91768Test |
| حقوق: | © Society of General Internal Medicine 2021. The final publication is available at Springer via https://doi.org/10.1007/s11606-021-07105-9Test |
| رقم الانضمام: | edsbas.F1F27A53 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 08848734 |
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| DOI: | 10.1007/s11606-021-07105-9 |