Comparative effectiveness of oral antidiabetic drugs in preventing cardiovascular mortality and morbidity: A network meta-analysis.
Comparative effectiveness of oral antidiabetic drugs in preventing cardiovascular mortality and morbidity: A network meta-analysis.
Blog Article
In the Guidance for Industry from the Food and Drug Administration in 2008, excess cardiovascular risk should be ruled out in trials of all new antidiabetic drugs; however, relatively few studies have focused on cardiovascular safety with antidiabetic drug use.We aimed to examine mortality and cardiovascular risk using a network meta-analysis.We searched the Medline, Embase, Cochrane, and ClinicalTrials.
gov registry databases in March 2016 to identify randomized controlled trials reporting cardiovascular risk with the following oral antidiabetic drugs: metformin, sulfonylureas, thiazolidinedione (TZD), dipeptidyl peptidase-4 (DPP4) inhibitors, and sodium-glucose co-transporter-2 (SGLT2) inhibitors.We assessed the differences in the risks of all-cause mortality, cardiovascular-related mortality, acute coronary syndrome (ACS), and myocardial infarction (MI) among antidiabetic drugs with fixed effect models for direct pairwise comparisons Application of Visible/Near Infrared Spectrometers to Quickly Detect the Nitrogen, Phosphorus, and Potassium Content of Chemical Fertilizers and Bayesian network meta-analyses to integrate direct and indirect comparisons.Of the 101,183 patients in 73 randomized controlled trials, 3,434 (3.
4%) died.The relative risks of all-cause mortality with SGLT2 inhibitor use were 0.68 (95% credible interval: 0.
57-0.80), 0.74 (0.
49-1.10), 0.63 (0.
46-0.87), 0.71 (0.
55-0.90), and 0.65 (0.
54-0.78), compared with placebo, metformin, sulfonylurea, TZD, and DPP4 inhibitor, respectively.The relative risks of cardiovascular-related mortality with SGLT2 inhibitor use were 0.
61 (0.50-0.76), 0.
81(0.36-1.90), 0.
52(0.31-0.88), 0.
66(0.49-0.91), and 0.
61(0.48-0.77), compared with placebo, metformin, sulfonylurea, TZD, and DPP4 inhibitor, respectively.
The relative risks of ACS with SGLT2 Developing a dengue forecast model using machine learning: A case study in China. inhibitor use was consistent with that of all-cause mortality.SGLT2 inhibitor use was associated with a lower risk of ACS than the other OADs and placebo.The relative risks of MI with SGLT2 inhibitor use were 0.
77 (0.63-0.93) and 0.
75 (0.60-0.94), compared with placebo and DPP4 inhibitor, respectively.
The currently available data provide the evidence of cardiovascular benefit from use of SGLT2 inhibitors to patients with type 2 diabetes, although additional results from ongoing studies will be pivotal.