Evaluation of the hypoglycemic and hypotensive efficacy of sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes: A model-based dose–response network meta-analysis

Intelligent Pharmacy Pub Date : 2025-04-01 DOI:10.1016/j.ipha.2025.02.001

Sanbao Chai , Fengqi Liu , Pei Li , Siyan Zhan , Feng Sun

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Abstract

Aims

To study the dose effect relationship of sodium-glucose cotransporter-2 inhibitor (SGLT-2i) in reducing blood glucose and blood pressure in type 2 diabetes mellitus (T2DM).

Materials and methods

We searched PubMed, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov for related literature, with the search period spanning from the establishment of each platform to May 1, 2024. The main analysis method used is model-based network meta-analysis.

Results

A total of 192 RCTs involving 67,677 patients with T2DM were included in this study. The results showed that SGLT-2i reduced glycated hemoglobin A1c (HbA1c) in T2DM by 0.50 % (95 % CI: 0.49 % ∼ 0.50 %) compared with placebo. The hypoglycemic effects of Luseogliflozin and Henagliflozin on HbA1c ranked first and second, with values of 0.92 % (95 % CI: 0.61 % ∼ 1.28 %) and 0.91 % (95 % CI: 0.61 % ∼ 1.36 %), respectively. Compared with placebo, the results showed that SGLT-2i lowered systolic blood pressure (SBP) by 3.23 mmHg (95 % CI: 3.19 mmHg ∼ 3.26 mmHg) and diastolic blood pressure (DBP) by 4.16 mmHg (95 % CI: 4.13 mmHg ∼ 4.18 mmHg) in patients with T2DM, respectively. Canagliflozin showed the greatest reduction in SBP and Luseogliflozin showed the greatest reduction in DBP, respectively.

Conclusions

The effect of SGLT-2i in reducing HbA1c in patients with T2DM increased with increasing daily dose, with Luseogliflozin and Henagliflozin being the most effective. SGLT-2i significantly reduced both SBP and DBP in T2DM, but there was no significant dose–response relationship. Among the SGLT-2i, Canagliflozin and Luseogliflozin exhibited better antihypertensive effects.

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评价钠-葡萄糖共转运蛋白-2抑制剂对2型糖尿病患者的降糖降压效果：基于模型的剂量-反应网络meta分析

目的研究钠-葡萄糖共转运蛋白-2抑制剂（SGLT-2i）对2型糖尿病（T2DM）降糖降压的剂量效应关系。材料与方法检索PubMed、Embase、Web of Science、Cochrane Library、clinicaltrials.gov等相关文献，检索时间从各平台建立至2024年5月1日。采用的主要分析方法是基于模型的网络元分析。结果共纳入192项随机对照试验，共纳入67,677例T2DM患者。结果显示，与安慰剂相比，SGLT-2i可将T2DM患者的糖化血红蛋白（HbA1c）降低0.50% （95% CI: 0.49% ~ 0.50%）。鲁西格列净和亨纳格列净对HbA1c的降糖作用排名第一和第二，分别为0.92% （95% CI: 0.61% ~ 1.28%）和0.91% （95% CI: 0.61% ~ 1.36%）。与安慰剂相比，结果显示SGLT-2i使T2DM患者的收缩压（SBP）分别降低3.23 mmHg （95% CI: 3.19 mmHg ~ 3.26 mmHg）和舒张压（DBP）分别降低4.16 mmHg （95% CI: 4.13 mmHg ~ 4.18 mmHg）。卡格列净和卢西格列净分别表现出最大的收缩压和舒张压的降低。结论SGLT-2i降低T2DM患者HbA1c的作用随着日剂量的增加而增强，以鲁西格列净和亨纳格列净效果最好。SGLT-2i可显著降低T2DM患者的收缩压和舒张压，但无显著的剂量-反应关系。SGLT-2i中，卡格列净和卢西格列净降压效果较好。

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Intelligent Pharmacy

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