Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials - Université de Lorraine
Article Dans Une Revue The Lancet. Diabetes & Endocrinology Année : 2024

Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials

1 University of Groningen [Groningen]
2 UNSW - University of New South Wales [Sydney]
3 RNSH - Royal North Shore Hospital
4 Berlin Institute of Health Center for Regenerative Therapies (BCRT)
5 DZHK - German Center for Cardiovascular Research
6 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
7 Mount Sinai Fuster Heart Hospital
8 MSSM - Icahn School of Medicine at Mount Sinai [New York]
9 UMMC - University of Mississippi Medical Center
10 Baylor Scott and White Research Institute [Dallas, TX, USA]
11 University of Toronto
12 Nuffield Department of Population Health [Oxford]
13 University of Oxford
14 YSM - Yale School of Medicine [New Haven, Connecticut]
15 The University of Sydney
16 Concord Repatriation General Hospital
17 Merck
18 Stanford School of Medicine [Stanford]
19 University of Texas Southwestern Medical Center [Dallas]
20 BHF GCRC - British Heart Foundation Glasgow Cardiovascular Research Centre
21 University of New South Wales [Kensington]
22 Imperial College London
23 BWH - Brigham & Women’s Hospital [Boston]
24 Brigham and Women's Hospital [Boston]
25 HMS - Harvard Medical School [Boston]
26 University of Colorado School of Medicine
27 University Hospital of Würzburg
28 UCL - University College of London [London]
29 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
30 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
31 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
32 Cardiovascular & Renal Clinical Trialists - CRCT - French-Clinical Research Infrastructure Network - F-CRIN [Paris]
33 University Medical Centre Groningen, Groningen University
Chih-Chin Liu
  • Fonction : Auteur

Résumé

Background Sodium glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) both improve cardiovascular and kidney outcomes in patients with type 2 diabetes. We sought to evaluate whether the benefits of SGLT2i are consistent in patients receiving and not receiving GLP-1RA. Methods We conducted a collaborative meta-analysis of trials included in the SGLT2 Inhibitor Meta-Analysis Cardio-Renal Trialists' Consortium, restricted to participants with diabetes.

Treatment effects from individual trials were obtained from Cox regression models and pooled using inverse variance weighted meta-analysis. Outcomes assessed included major adverse cardiovascular events ([MACE] myocardial infarction, stroke or cardiovascular death), hospitalisation for heart failure (HF) or cardiovascular death, CKD progression (≥40% decline in estimated glomerular filtration rate [eGFR], kidney failure or death due to kidney failure), as well as safety outcomes. Results Across 12 randomised, double-blind, placebo-controlled trials, 3,065/72,970 (4.0%) participants with diabetes were using GLP-1RA at baseline. SGLT2i reduced the risk of MACE in participants receiving and not receiving GLP-1RA (hazard ratio [HR] 0.81, 95% CI 0.63-1.03 and HR 0.90, 95% CI 0.86-0.94, respectively; P-heterogeneity=0.31). Effects on hospitalisation for HF or cardiovascular death (HR 0.76, 95% CI 0.57-1.01 and HR 0.78, 95% CI 0.74-0.82, respectively; P-heterogeneity=0.90) and CKD progression (HR 0.65, 95% CI 0.46-0.94 and HR 0.67, 95% CI 0.62-0.72, respectively; P-heterogeneity=0.81) were also consistent regardless of GLP-1RA use. Fewer serious adverse events occurred with SGLT2i

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Dates et versions

hal-04682483 , version 1 (30-08-2024)

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Ellen Apperloo, Brendon L Neuen, Robert A Fletcher, Niels Jongs, Stefan D Anker, et al.. Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials. The Lancet. Diabetes & Endocrinology , 2024, 12 (8), pp.545-557. ⟨10.1016/S2213-8587(24)00155-4⟩. ⟨hal-04682483⟩
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