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
{"title":"钠-葡萄糖共转运蛋白-2抑制剂在2型糖尿病和其他心血管疾病危险因素患者中的安全性结局:一项系统回顾和荟萃分析","authors":"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","doi":"10.1097/XCE.0000000000000284","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p><p><strong>Areas covered: </strong>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.</p><p><strong>Expert opinion/commentary: </strong>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.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171571/pdf/","citationCount":"1","resultStr":"{\"title\":\"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.\",\"authors\":\"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\",\"doi\":\"10.1097/XCE.0000000000000284\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Sodium-glucose cotransporter-2 inhibitors (SGLT2-Is) have emerged as standard therapy for heart failure. 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引用次数: 1
摘要
钠-葡萄糖共转运蛋白-2抑制剂(SGLT2-Is)已成为心力衰竭的标准治疗方法。我们的目的是评估SGLT2-Is在高危心血管疾病患者中的安全性。涉及领域:对SGLT2-Is与安慰剂在心脏病或心力衰竭高危患者中的随机对照试验进行了电子数据库检索。采用随机效应模型对数据进行汇总。采用优势比(OR)和95%置信区间(CI)比较两组间的8项安全性结果。该分析包括10项研究,共71 553名参与者,其中39 053人接受了SGLT2-Is;男性28809例,女性15655例(平均年龄65.2岁)。平均随访时间2.3年,随访范围0.8 ~ 4.2年。SGLT2-Is组AKI发生率显著降低(OR = 0.8;95% CI 0.74-0.90),不良反应发生率显著降低(OR = 0.9;95% CI 0.83-0.96)。骨折发生率差异无统计学意义(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)和尿路感染(OR = 1.1;95% ci 1.00-1.22)。相比之下,DKA (OR = 2.4;95% CI 1.65-3.60)和体积损耗(OR = 1.2;95% CI 1.07-1.41), SGLT2-Is组较高。专家意见/评论:SLGT2-Is的益处大于不良事件的风险。它们可以降低AKI的风险,但与DKA和容量衰竭的风险增加有关。需要进一步的研究来监测SGLT2-Is更广泛的安全性结果。
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.
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.