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| 標題: | Impact of SGLT2 inhibitors on patient outcomes: a network meta-analysis |
| 作者: | Chen, Jui-Yi
Pan, Heng-Chih
Shiao, Chih-Chung
Chuang, Min-Hsiang
See, Chun Yin
Yeh, Tzu-Hsuan
Yang, Yafei
Chu, Wen-Kai
Wu, Vin-Cent |
| 貢獻者: | Chi Mei Med Ctr, Dept Internal Med, Div Nephrol
Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
Keelung Chang Gung Mem Hosp, Dept Internal Med, Div Nephrol
Chang Gung Univ, Coll Med
Natl Taiwan Univ, Grad Inst Clin Med, Coll Med
Keelung Chang Gung Mem Hosp, Community Med Res Ctr
Camillian St Marys Hosp Luodong, Dept Internal Med, Div Nephrol
St Marys Jr Coll Med Nursing & Management
Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Internal Med ,Div Nephrol
Everan Hosp, Dept Internal Med, Div Nephrol
Natl Taiwan Univ Hosp, Dept Internal Med
Natl Taiwan Univ Hosp, NSARF, Study Grp ARF
Taiwan Primary Aldosteronism Investigators |
| 關鍵字: | SGLT2 inhibitor
Diabetes
Heart failure
Chronic kidney disease
Network meta-analysis |
| 日期: | 2023 |
| 上傳時間: | 2024-12-25 11:03:33 (UTC+8) |
| 出版者: | BMC |
| 摘要: | BackgroundA comprehensive network meta-analysis comparing the effects of individual sodium-glucose cotransporter 2 (SGLT2) inhibitors on patients with and without comorbidities including diabetes mellitus (DM), heart failure (HF), and chronic kidney disease (CKD) has not been previously conducted.MethodsWe searched PubMed, Embase, Cochrane, and ClinicalTrials.gov for randomized controlled trials up to March 28, 2023. Network meta-analysis using a random-effects model was conducted to calculate risk ratios (RRs). Risk of Bias tool 2.0 was used to assess bias, and CINeMA to assess the certainty of evidence. In the subgroup analysis, the SGLT2 inhibitors were classified into highly (dapagliflozin, empagliflozin, and ertugliflozin) and less selective SGLT2 inhibitors (canagliflozin and sotagliflozin).ResultsA total of fourteen trials with 75,334 patients were analyzed. Among these, 40,956 had taken SGLT2 inhibitors and 34,378 had not. One of the main results with particular findings was empagliflozin users had a significantly lower risk of all-cause death compared to dapagliflozin users in DM population (RR: 0.81, 95% CI 0.69-0.96). In HF population, sotagliflozin users had a borderline significantly lower risk of CV death or hospitalization for HF (HHF) than dapagliflozin users (RR: 0.90, 95% CI 0.80-1.01). In non-HF population, those who used canagliflozin had a significantly lower risk of CV death or HHF compared with those who used dapagliflozin (RR: 0.75, 95% CI 0.58-0.98). At last, for HF patients, those who used less selective SGLT2 inhibitors had a significantly lower risk of MACEs compared to those who used highly selective SGLT2 inhibitors (RR: 0.75, 95% CI 0.62-0.90).ConclusionsOur network meta-analysis revealed that empagliflozin users with diabetes experienced a lower risk of dying from any cause than those using dapagliflozin. Additionally, canagliflozin users demonstrated a reduced risk of cardiovascular death or HHF compared to dapagliflozin users in those without HF. In HF patients, less selective SGLT2 inhibitors showed superior CV composite outcomes, even surpassing the performance of highly selective SGLT2 inhibitors.Trial registration: PROSPERO [CRD42022361906].ConclusionsOur network meta-analysis revealed that empagliflozin users with diabetes experienced a lower risk of dying from any cause than those using dapagliflozin. Additionally, canagliflozin users demonstrated a reduced risk of cardiovascular death or HHF compared to dapagliflozin users in those without HF. In HF patients, less selective SGLT2 inhibitors showed superior CV composite outcomes, even surpassing the performance of highly selective SGLT2 inhibitors.Trial registration: PROSPERO [CRD42022361906]. |
| 關聯: | Cardiovascular Diabetology, v.22, n.1, Article 290 |
| 顯示於類別: | [保健營養系(所) ] 期刊論文
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