High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials

Diabetes, Obesity and Metabolism - Tập 23 Số 9 - Trang 2125-2136 - 2021
Fang‐Hong Shi1, Hao Li2,3, Long Shen4, Jingjing Fu5, Jing Ma5, Zhi‐Chun Gu1, Hou‐Wen Lin1,6
1Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
2Clinical Research Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
3Department of Pharmacy, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
4Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
5Department of Endocrinology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
6School of Medicine, Tongji University, Shanghai, China

Tóm tắt

AbstractAimTo determine the overall efficacy of high‐ versus low‐dose sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D).Material and MethodsA literature search using MEDLINE, EMBASE and the Cochrane Library was performed from 1 January 2006 to 23 September 2020. Random effects models were used to calculate mean differences (MDs) and pooled relative risk (RR). Prespecified subgroup analyses for each SGLT2 inhibitor, follow‐up and controls were performed. Leave‐one‐out sensitivity and meta‐regression analyses were conducted.ResultsA total of 51 randomized controlled trials involving 23 989 participants (weighted mean age, 58.9 years; men, 58.8%) were eligible for our meta‐analysis. For glycaemic regulation ability, a significant reduction in HbA1c (MD −0.080%, 95% confidence interval [CI] −0.100 to −0.060), fasting plasma glucose (MD −0.227 mmol/L, 95% CI −0.282 to −0.173) and postprandial plasma glucose (MD −0.834 mmol/L, 95% CI −1.268 to −0.400) levels was observed in the high‐dose SGLT2 inhibitor group. Treatment with high‐dose SGLT2 inhibitors enabled easier achievement of the target (HbA1c <7%) than low‐dose SGLT2 inhibitors (RR 1.148, 95% CI 1.104 to 1.193). High‐dose SGLT2 inhibitor‐based treatment resulted in more efficient regulation of body weight and blood pressure (body weight: MD −0.346 kg, 95% CI −0.437 to −0.254; systolic blood pressure: MD −0.583 mmHg, 95% CI −0.903 to −0.263; diastolic blood pressure: MD −0.352 mmHg, 95% CI −0.563 to −0.142). The results were similar in sensitivity analyses.ConclusionsThe overall efficacy of SGLT2 inhibitors, mainly canagliflozin, dapagliflozin and empagliflozin, was found to be dose dependent.

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Tài liệu tham khảo

10.1016/S0140-6736(17)30058-2

10.1161/CIRCULATIONAHA.116.021887

10.2337/dc21-S009

10.1093/eurheartj/ehz486

10.1080/00325481.2016.1167570

10.1111/dom.13611

10.1038/nrendo.2011.243

10.1111/dom.13101

10.1136/bmj.g7647

Davlouros PA, 2018, Transcatheter aortic valve replacement and stroke: a comprehensive review, J Geriatr Cardiol., 15, 95

10.3389/fphar.2019.01066

10.1210/clinem/dgaa586

10.1136/bmj.d5928

10.1002/sim.1186

10.1016/j.cgh.2019.05.056

10.1136/bmj.315.7109.629

10.2337/dc08-1863

10.1186/s12933-015-0314-0

10.1111/j.1463-1326.2011.01406.x

10.1002/cpdd.16

10.1038/clpt.2008.251

10.1111/dom.13194

10.1111/dom.13681

10.1111/dom.13116

10.1007/s13300-017-0354-4

10.1007/s13300-017-0358-0

10.1111/jdi.12156

10.1111/obr.12755

10.1002/oby.22066

10.1016/j.clinthera.2019.01.001

10.2337/dc13-2762

10.2337/dc18-2207

10.1016/j.jash.2014.01.007

10.2337/db16-0049

10.14740/jocmr2467w

10.2337/dc14-2365

10.1016/j.phrs.2020.105068

10.1016/j.jcjd.2019.07.003

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Thông tin xuất bản

Diabetes, Obesity and Metabolism

Tập 23 Số 9

2125-2136

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