Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 1 de 1
Filter
Add more filters










Database
Language
Publication year range
1.
J Clin Endocrinol Metab ; 106(10): 3060-3067, 2021 09 27.
Article in English | MEDLINE | ID: mdl-34125217

ABSTRACT

BACKGROUND: Sodium glucose co-transporter 2 inhibitors (SGLT2is) prevent hospitalization resulting from heart failure (HHF). However, patients with type 2 diabetes mellitus use multiple antihyperglycemic drugs to achieve glycosylated hemoglobin (HbA1c) targets. In these drug combinations, the risk of HHF is unpredictable and so is the parallel effect of glucose-lowering. PURPOSE: To examine the impact of antihyperglycemic drugs and their association on HHF. DATA SOURCES: Forty randomized controlled trials (RCTs) reporting HHF. STUDY SELECTION: Published RCTs were the data source. DATA EXTRACTION: Incidence rates of HHF. DATA SYNTHESIS: Random additive-effects network meta-analysis showed that metformin (P = 0.55), sulfonylureas (P = 0.51), glucagon-like peptide-1 receptor-agonist (P = 0.16), and dipeptidyl peptidase 4 inhibitors (DPP4is; P = 0.54) were neutral on the risk of HHF. SGLT2is and SGLT2is + DPP4is reduced the risk of HHF with a hazard ratio (HR) of 0.68 (95% CI, 0.60-0.76; P < 0.0001) and 0.70 (95% CI, 0.60-0.81; P < 0.0001), respectively. Increased risk of HHF was associated with thiazolidinediones (TZDs) as monotherapy or in combination with DPP4is (HR: 1.45; 95% CI, 1.18-1.78; P = 0.0004) and 1.49 (95% CI, 1.18-1.88; P = 0.0008), respectively. Regardless of the therapy, a 1% reduction in HbA1c reduced the risk of HHF by 31.3% (95% CI, 9-48; P = 0.009). LIMITATIONS: There are no data to verify drug combinations available for clinical use and to discriminate the effect of drugs within each of the therapeutic classes. CONCLUSIONS: The risk of HHF is reduced by SGLT2is as monotherapy or in combination with DPP4is and increased by TZDs as monotherapy or in combination. Glucose-lowering provides an additive effect of reducing HHF.


Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Diabetic Cardiomyopathies/epidemiology , Heart Failure/epidemiology , Hospitalization/statistics & numerical data , Hypoglycemic Agents/administration & dosage , Diabetes Mellitus, Type 2/complications , Diabetic Cardiomyopathies/etiology , Diabetic Cardiomyopathies/prevention & control , Dipeptidyl-Peptidase IV Inhibitors/administration & dosage , Drug Therapy, Combination , Female , Heart Failure/etiology , Heart Failure/prevention & control , Humans , Incidence , Male , Middle Aged , Network Meta-Analysis , Proportional Hazards Models , Randomized Controlled Trials as Topic , Sodium-Glucose Transporter 2 Inhibitors/administration & dosage , Thiazolidinediones/administration & dosage , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...