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
Por:
Escobar, C, Barrios, V, Cosin, J, Martinez, JMG, Rodrigo, AIH, Cortes, CO, Llergo, JT, Requeijo, C, Sola, I, Zapata, MJM
Publicada:
1 mar 2021
Ahead of Print:
1 ene 2021
Resumen:
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.
Filiaciones:
Escobar, C:
Univ Hosp La Paz, Cardiol Dept, Paseo Castellana 261, Madrid 28046, Spain
Barrios, V:
Univ Hosp Ramon y Cajal, Cardiol Dept, Madrid, Spain
Cosin, J:
Hosp Arnau Vilanova, Cardiol Dept, Valencia, Spain
Martinez, JMG:
Hosp Son Llatzer, Cardiol Dept, Palma De Mallorca, Baleares, Spain
Rodrigo, AIH:
Univ Hosp Fdn Alcorcon, Cardiol Dept, Madrid, Spain
Cortes, CO:
Hosp San Pedro Alcantara, Cardiol Dept, Caceres, Spain
Llergo, JT:
Complejo Hosp Jaen, Cardiol Dept, Jaen, Spain
Requeijo, C:
CIBERESP, Inst Invest Biomed St Pau, Ctr Cochrane Iberoamer, Barcelona, Spain
Sola, I:
CIBERESP, Inst Invest Biomed St Pau, Ctr Cochrane Iberoamer, Barcelona, Spain
Zapata, MJM:
CIBERESP, Inst Invest Biomed St Pau, Ctr Cochrane Iberoamer, Barcelona, Spain
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