Risk of lower limb amputation in diabetic patients using SGLT2 inhibitors versus DPP4 inhibitors or GLP-1 agonists: a meta-analysis of 2 million patients.

IF 3.4 3区医学 Q2 PHARMACOLOGY & PHARMACY

Therapeutic Advances in Drug Safety Pub Date : 2023-01-01 DOI:10.1177/20420986231178126

Yang Lu, Caiyun Guo

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引用次数: 1

Abstract

Background: The objective of this review was to assess the risk of lower limb amputation (LLA) in type 2 diabetic patients based on the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) versus dipeptidyl peptidase 4 inhibitors (DPP4i) or glucagon-like peptide-1 receptor agonists (GLP1a).

Methods: PubMed, CENTRAL, Scopus, Web of Science, and Embase were referenced for articles published up to 5 February 2023. All types of studies comparing the drugs for LLA risk and reporting hazard ratios (HR) were included.

Results: Thirteen studies with 2,095,033 patients were included. Meta-analysis of eight studies comparing SGLT2i with Dipeptidyl peptidase inhibitors (DPPi) showed that there was no difference in the risk of LLA between the two drug groups (HR: 0.98 95% CI: 0.73, 1.31 I² = 89%). The outcomes were unchanged on sensitivity analysis. Another pooled analysis of six studies found no significant difference in the risk of LLA between SGLT2i and GLP1a users (HR: 1.26; 95% CI: 0.99, 1.60; I² = 69%). The exclusion of a single study showed an increased risk of LLA with SGLT2i (HR: 1.35; 95% CI: 1.14, 1.60; I² = 14%).

Conclusion: The current updated meta-analysis found no significant difference in the risk of LLA between SGLT2i and DPP4i users. A tendency of increased risk of LLA was noted with SGLT2i as compared to GLP1a. Further studies shall increase the robustness of current findings.

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糖尿病患者使用SGLT2抑制剂与DPP4抑制剂或GLP-1激动剂的下肢截肢风险:一项200万患者的荟萃分析

背景:本综述的目的是评估基于钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)与二肽基肽酶4抑制剂(DPP4i)或胰高血糖素样肽-1受体激动剂(GLP1a)使用的2型糖尿病患者下肢截肢(LLA)的风险。方法:检索截至2023年2月5日发表的文章，检索PubMed、CENTRAL、Scopus、Web of Science和Embase。所有类型的比较药物LLA风险和报告风险比(HR)的研究都被纳入。结果:纳入13项研究，2,095,033例患者。8项比较SGLT2i与二肽基肽酶抑制剂(DPPi)的研究荟萃分析显示，两种药物组之间LLA的风险无差异(HR: 0.98 95% CI: 0.73, 1.31 I2 = 89%)。敏感性分析结果没有变化。另一项对6项研究的汇总分析发现，SGLT2i和GLP1a使用者发生LLA的风险无显著差异(HR: 1.26;95% ci: 0.99, 1.60;i2 = 69%)。排除一项研究表明，SGLT2i患者发生LLA的风险增加(HR: 1.35;95% ci: 1.14, 1.60;i2 = 14%)。结论:当前更新的荟萃分析发现SGLT2i和DPP4i使用者之间LLA的风险无显著差异。与GLP1a相比，SGLT2i有增加LLA风险的趋势。进一步的研究将增加目前研究结果的稳健性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Drug Safety Medicine-Pharmacology (medical)

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

9 weeks

期刊介绍： Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.