Safety outcomes of sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes and other risk factors for cardiovascular disease: a systematic review and meta-analysis.

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular Endocrinology & Metabolism Pub Date : 2023-05-08 eCollection Date: 2023-06-01 DOI:10.1097/XCE.0000000000000284
Radhika Deshpande, Raj Patel, Manjari R Regmi, Mohsin Salih, Robert Kropp, Basma Al-Bast, Muhammad A Sheikh, Andrew Sagalov, Abhishek Kulkarni, Momin Siddique, Shruti Hegde, Mukul Bhattarai
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引用次数: 0

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2-Is) have emerged as standard therapy for heart failure. We aim to assess the safety of SGLT2-Is in patients with a high risk of cardiovascular disease.

Areas covered: An electronic database search was conducted for randomized control trials comparing SGLT2-Is to placebo in patients with a high risk of cardiac disease or heart failure. Data were pooled for outcomes using random-effect models. The odds ratio (OR) and 95% confidence interval (CI) were used to compare eight safety outcomes between the two groups. The analysis included ten studies with 71 553 participants, among whom 39 053 received SGLT2-Is; 28 809 were male and 15 655 were female (mean age, 65.2 years). The mean follow-up period was 2.3 years with the range being 0.8-4.2 years. The SGLT2-Is group had a significant reduction in AKI (OR = 0.8;95% CI 0.74-0.90) and serious adverse effects (OR = 0.9; 95% CI 0.83-0.96) as compared to placebo. No difference was found in fracture (OR = 1.1; 95% CI 0.91-1.24), amputation (OR = 1.1; 95% CI 1.00-1.29), hypoglycemia (OR 0.98;95% CI 0.83-1.15), and UTI (OR = 1.1; 95% CI 1.00-1.22). In contrast, DKA (OR = 2.4; 95% CI 1.65-3.60) and volume depletion (OR = 1.2; 95% CI 1.07-1.41) were higher in SGLT2-Is group.

Expert opinion/commentary: The benefits of SLGT2-Is outweigh the risk of adverse events. They may reduce the risk of AKI but are associated with an increased risk of DKA and volume depletion. Further studies are warranted to monitor a wider range of safety outcomes of SGLT2-Is.

Abstract Image

Abstract Image

钠-葡萄糖共转运体-2 抑制剂对 2 型糖尿病和其他心血管疾病风险因素患者的安全性结果:系统综述和荟萃分析。
钠-葡萄糖共转运体-2抑制剂(SGLT2-Is)已成为治疗心力衰竭的标准疗法。我们旨在评估 SGLT2-Is 在心血管疾病高危患者中的安全性:通过电子数据库检索了在心脏病或心力衰竭高危患者中比较 SGLT2-Is 与安慰剂的随机对照试验。采用随机效应模型对结果数据进行了汇总。采用几率比(OR)和 95% 置信区间(CI)来比较两组之间的八项安全性结果。分析包括 10 项研究,共有 71 553 名参与者,其中 39 053 人接受了 SGLT2-Is;男性 28 809 人,女性 15 655 人(平均年龄 65.2 岁)。平均随访时间为 2.3 年,范围为 0.8-4.2 年。与安慰剂相比,SGLT2-Is 组的 AKI(OR = 0.8;95% CI 0.74-0.90)和严重不良反应(OR = 0.9;95% CI 0.83-0.96)显著减少。在骨折(OR = 1.1;95% CI 0.91-1.24)、截肢(OR = 1.1;95% CI 1.00-1.29)、低血糖(OR 0.98;95% CI 0.83-1.15)和尿毒症(OR = 1.1;95% CI 1.00-1.22)方面没有发现差异。相比之下,SGLT2-Is 组的 DKA(OR = 2.4;95% CI 1.65-3.60)和容量耗竭(OR = 1.2;95% CI 1.07-1.41)发生率较高:专家意见/评论:SLGT2-Is 的益处大于不良事件的风险。专家意见/评论:SLGT2-Is 的益处大于不良事件的风险。它们可降低发生 AKI 的风险,但与 DKA 和容量耗竭的风险增加有关。有必要开展进一步研究,以监测 SGLT2-Is 的更广泛安全性结果。
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
Cardiovascular Endocrinology & Metabolism
Cardiovascular Endocrinology & Metabolism CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.60
自引率
0.00%
发文量
24
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