SGLT2 inhibitors and GLP1 agonists administered without metformin compared to other glucose-lowering drugs in patients with type 2 diabetes mellitus to prevent cardiovascular events: A systematic review.

Autor: Escobar C; Cardiology Department, University Hospital La Paz, Madrid, Spain., Barrios V; Cardiology Department, University Hospital Ramon y Cajal, Madrid, Spain., Cosín J; Cardiology Department, Hospital Arnau de Vilanova, Valencia, Spain., Gámez Martínez JM; Cardiology Department, Hospital Son Llàtzer, Palma de Mallorca, Baleares, Spain., Huelmos Rodrigo AI; Cardiology Department, University Hospital Fundación Alcorcón, Madrid, Spain., Ortíz Cortés C; Cardiology Department, Hospital San Pedro de Alcántara, Caceres, Spain., Torres Llergo J; Cardiology Department, Complejo Hospitalario de Jaen, Spain., Requeijo C; Centro Cochrane Iberoamericano, Institut d'Investigació Biomèdica Sant Pau, CIBERESP, Barcelona, Spain., Solà I; Centro Cochrane Iberoamericano, Institut d'Investigació Biomèdica Sant Pau, CIBERESP, Barcelona, Spain., Martínez Zapata MJ; Centro Cochrane Iberoamericano, Institut d'Investigació Biomèdica Sant Pau, CIBERESP, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2021 Mar; Vol. 38 (3), pp. e14502. Date of Electronic Publication: 2021 Jan 04.
DOI: 10.1111/dme.14502
Abstrakt: Objectives: To assess the efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose co-transporter 2 (SGLT2) inhibitors, administered without metformin on cardiovascular outcomes in type 2 diabetes patients.
Methods: A systematic review was performed according to Cochrane's methodological standards. We included randomized clinical trials (RCTs) on adult type 2 diabetes patients, assessing the efficacy of SGLT2 inhibitors and GLP1-RAs compared to other glucose-lowering drugs and/or RCTs that presented data of a subgroup of type 2 diabetes patients without metformin use at baseline. The main outcome was the reduction of the risk of any major adverse cardiovascular events (MACE) reported individually or as a composite outcome.
Results: Five RCTs including 50,725 type 2 diabetes patients, of whom 10,013 had not received metformin, were included in this meta-analysis. Three of these studies assessed the efficacy of GLP1-RAs and two of SGLT2 inhibitors. In patients without metformin at baseline, GLP1-RAs in comparison with placebo reduced the risk of MACE significantly by 20% (HR: 0.80; 95% CI: 0.71-0.89). SGLT2 inhibitors also significantly reduced the risk of MACE by 32% (HR: 0.68; 95% CI: 0.57-0.81).
Conclusions: SGLT2 inhibitors and GLP1-RAs provided without metformin at baseline may reduce the risk of MACE in comparison with placebo in type 2 diabetes patients at increased risk of cardiovascular events.
(© 2020 Diabetes UK.)
Databáze: MEDLINE
Externí odkaz: