Comparison of glucagons like peptide-1 receptor agonists and dipeptidyl peptide-4 inhibitors regarding cardiovascular safety and mortality in type 2 diabetes mellitus: A network meta-analysis

  • Author Footnotes
    1 These authors contributed equally to this work.
    Jing Hu
    Correspondence
    Corresponding author.
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Deptarment of Pharmacy, Shanghai Ruijin Rehabilitation Hospital, Shanghai 200023, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Liyun Chen
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
Published:September 01, 2020DOI:https://doi.org/10.1016/j.pcd.2020.08.012

      Highlights

      • Compared with DPP-4is, SGLT-2is can reduce MACE, CV death, nonfatal MI and all-cause mortality.
      • For nonfatal stroke, DPP-4is and SGLT-2is have no statistically significant difference.
      • Canagliflozin and Empagliflozin were the most beneficial in reducing CV events and all-cause mortality.

      Abstract

      Aim

      The effects of dipeptidyl peptide-4 inhibitors (DPP-4is) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is) on type 2 diabetes mellitus (T2DM) on cardiovascular events and all-cause mortality were compared.

      Methods

      The literature on DPP-4is and SGLT-2is treatment of T2DM was searched through Pubmed, Embase, and the web of science databases with the search deadline May 15, 2020. Network meta-analysis (NMA) was used to compare the effects of two types of inhibitors on cardiovascular events (major adverse cardiovascular events (MACE), nonfatal myocardial infarction (MI), nonfatal stroke, and cardiovascular (CV) death) and all-cause mortality in T2DM patients.

      Results

      A total of 15 articles were screened, including 125,796 patients. Compared with DPP-4is, SGLT-2is can significantly reduce MACE [OR: 0.86 95% CI (0.78, 0.92)], CV death [OR: 0.85 95% CI (0.71, 1.01)], nonfatal MI [OR: 0.84 95%CI (0.74, 0.95)] and all-cause mortality [OR: 0.78 95% CI (0.69, 0.89)]. For nonfatal stroke, DPP-4is and SGLT-2is have no statistically significant difference [OR: 0.99 95% CI (0.91, 1.07)].

      Conclusion

      These data indicate that SGLT-2is is more beneficial to MACE and all-cause mortality in T2DM patients than DPP-4is.

      Keywords

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