Sodium-glucose co-transporter-2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta-analysis of randomized controlled trials
单位:[1]Department of Pharmacy, Peking University Third Hospital, Beijing, China[2]Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana[3]Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana[4]Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China医技科室药学部首都医科大学附属北京友谊医院[5]Division of Nephrology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania[6]Department of Endocrinology, Beijing Pinggu Hospital, Beijing, China[7]Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, China
Aim: To compare the associations of individual sodium-glucose co-transporter-2 (SGLT2) inhibitors with adverse renal outcomes in patients with type 2 diabetes mellitus (T2DM). Methods: PubMed, EMBASE, CENTRAL and ClinicalTrials. gov were searched for studies published up to May 24, 2016, without language or date restrictions. Randomized trials that reported at least 1 renal-related adverse outcome in patients with T2DM treated with SGLT2 inhibitors were included. Pairwise and network meta-analyses were carried out to calculate the odds ratios (ORs) with 95% confidence intervals (CIs), and a cumulative meta-analysis was performed to assess the robustness of evidence. Results: In total, we extracted 1334 composite renal events among 39 741 patients from 58 trials, and 511 acute renal impairment/failure events among 36 716 patients from 53 trials. Dapagliflozin was significantly associated with a greater risk of composite renal events than placebo (OR 1.64, 95% CI 1.26-2.13). Empagliflozin seemed to confer a lower risk than placebo (OR 0.63, 95% CI 0.54-0.72), canagliflozin (OR 0.48, 95% CI 0.29-0.82) and dapagliflozin (OR 0.38, 95% CI 0.28-0.51). With regard to acute renal impairment/failure, only empagliflozin was significantly associated with a lower risk than placebo (OR 0.72, 95% CI 0.60-0.86). The cumulative meta-analysis indicated the robustness of our significant findings. Conclusions: The present meta-analysis indicated that dapagliflozin may increase the risk of adverse renal events, while empagliflozin may have a protective effect among patients with T2DM. Further data from large well-conducted randomized controlled trials and a real-world setting are warranted.
基金:
Indiana University Health-Indiana University School of Medicine Strategic Research Initiative
第一作者单位:[1]Department of Pharmacy, Peking University Third Hospital, Beijing, China[2]Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana[3]Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
通讯作者:
通讯机构:[2]Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana[3]Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana[*1]Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Boulevard, 46202 Indianapolis, IN.
推荐引用方式(GB/T 7714):
Tang Huilin,Li Dandan,Zhang Jingjing,et al.Sodium-glucose co-transporter-2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta-analysis of randomized controlled trials[J].DIABETES OBESITY & METABOLISM.2017,19(8):1106-1115.doi:10.1111/dom.12917.
APA:
Tang, Huilin,Li, Dandan,Zhang, Jingjing,Li, Yufeng,Wang, Tiansheng...&Song, Yiqing.(2017).Sodium-glucose co-transporter-2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta-analysis of randomized controlled trials.DIABETES OBESITY & METABOLISM,19,(8)
MLA:
Tang, Huilin,et al."Sodium-glucose co-transporter-2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta-analysis of randomized controlled trials".DIABETES OBESITY & METABOLISM 19..8(2017):1106-1115