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

• Published in: Primary care diabetes Vol. 15; no. 2; pp. 208 - 211
• Main Authors: Wei, Xu-Bin, Wei, Wei, Ding, Liang-Liang, Liu, Shu-Yan
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2021
• Subjects: Cardiorenal events; GLP-1 RAs; Network meta-analysis; SGLT2 inhibitors; Type 2 diabetes; Type 2 diabetes; GLP-1 RAs; ACD; RCT; Network meta-analysis; CI; HHF; SUCRA; HR; CVD; KFP; MACE; Cardiorenal events; MI; SGLT2 inhibitors
• ISSN: 1751-9918; 1878-0210
• DOI: 10.1016/j.pcd.2020.08.017

•The relative benefit of new antidiabetic drugs for cardiorenal endpoints is unclear.•The most efficacious drugs vary with different cardiorenal endpoints.•Subcutaneous semaglutide and albiglutide are most effective for cardiac events.•Canagliflozin and empagliflozin are most effective for heart failure hospitalization.•Dapagliflozin and empagliflozin are most effective for kidney function progression. 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.