التفاصيل البيبلوغرافية
| العنوان: |
Comparative effectiveness of cardiovascular, renal and safety outcomes of second‐line antidiabetic drugs use in people with type 2 diabetes: A systematic review and network meta‐analysis of randomised controlled trials |
| المؤلفون: |
Sim, Ruth, Chong, Chun Wie, Loganadan, Navin K., Fong, Alan Y. Y., Navaravong, Leenhapong, Hussein, Zanariah, Khunti, Kamlesh, Lee, Shaun Wen Huey |
| المصدر: |
Diabetic Medicine ; volume 39, issue 3 ; ISSN 0742-3071 1464-5491 |
| بيانات النشر: |
Wiley |
| سنة النشر: |
2022 |
| المجموعة: |
Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: |
Aims To compare the cardiovascular, renal and safety outcomes of second‐line glucose‐lowering agents used in the management of people with type 2 diabetes. Methods MEDLINE, EMBASE and CENTRAL were searched from inception to 13 July 2021 for randomised controlled trials comparing second‐line glucose lowering therapies with placebo, standard care or one another. Primary outcomes included cardiovascular and renal outcomes. Secondary outcomes were non‐cardiovascular adverse events. Risk ratios (RRs) and corresponding confidence intervals (CI) or credible intervals (CrI) were reported within pairwise and network meta‐analysis. The quality of evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) criteria. Number needed to treat (NNT) and number needed (NNH) to harm were calculated at 5 years using incidence rates and RRs. PROSPERO (CRD42020168322). Results We included 38 trials from seven classes of glucose‐lowering therapies. Both sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i) and glucagon‐like peptide 1 receptor agonists (GLP1RA) showed moderate to high certainty in reducing risk of 3‐point major adverse cardiovascular events, 3P‐MACE (network estimates: SGLT2i [RR 0.90; 95% CrI 0.84–0.96; NNT, 59], GLP1RA [RR 0.88; 95% CrI 0.83–0.93; NNT, 50]), cardiovascular death, all‐cause mortality, renal composite outcome and macroalbuminuria. SGLT2i also showed high certainty in reducing risk of hospitalization for heart failure (hHF), ESRD, acute kidney injury, doubling in serum creatinine and decline in eGFR. GLP1RA were associated with lower risk of stroke (high certainty) while glitazone use was associated with an increased risk of hHF (very low certainty). The risk of developing ESRD was lower with the use of sulphonylureas (low certainty). For adverse events, sulphonylureas and insulin were associated with increased hypoglycaemic events (very low to low certainty), while GLP1RA increased the risk of gastrointestinal side effects leading to treatment ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1111/dme.14780 |
| الإتاحة: |
https://doi.org/10.1111/dme.14780Test |
| حقوق: |
http://onlinelibrary.wiley.com/termsAndConditions#vorTest |
| رقم الانضمام: |
edsbas.E1B5BD2A |
| قاعدة البيانات: |
BASE |
