Evidence map›Paper›PMID 35296336›Full record

ArticleCardiovascular diabetology2022

The effect of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors on cardiorenal outcomes: a network meta-analysis of 23 CVOTs.

Dario Giugliano, Miriam Longo, Simona Signoriello, Maria Ida Maiorino, Bruno Solerte, Paolo Chiodini, Katherine Esposito

Open access · goldAbstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 8 pooled it
19.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 8 syntheses or guidelines pooled it, 143 citations in OpenAlex.

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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Dario GiuglianoDepartment of Advanced Medical and Surgical Sciences, PhD of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy. dario.giugliano@unicampania.it.
Miriam LongoDepartment of Advanced Medical and Surgical Sciences, PhD of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Simona SignorielloMedical Statistics Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Maria Ida MaiorinoDepartment of Advanced Medical and Surgical Sciences, PhD of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Bruno SolerteDipartimento di Medicina Interna e Terapia Medica, Università Degli Studi Di Pavia, Pavia, Italy.
Paolo ChiodiniMedical Statistics Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Katherine EspositoDepartment of Advanced Medical and Surgical Sciences, PhD of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
University of Campania "Luigi Vanvitelli" · ITUniversity of Pavia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium glucose co-transporter-2 (SGLT-2) inhibitors reduce cardiorenal outcomes. We performed a network meta-analysis to compare the effect on cardiorenal outcomes among GLP-1 RAs, SGLT-2 inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors.

methodsWe searched the PUBMED, Embase and Cochrane databases for relevant studies published up until 10 December 2021. Cardiovascular and renal outcome trials reporting outcomes on GLP-1RA, SGLT-2 inhibitors and DPP-4 inhibitors in patients with or without type 2 diabetes mellitus were included. The primary outcome was major adverse cardiovascular events (MACE); other outcomes were cardiovascular and total death, nonfatal myocardial infarction (MI), nonfatal stroke, hospitalization for heart failure (HHF), and renal outcome.

resultsTwenty-three trials enrolling a total number of 181,143 participants were included. DPP-4 inhibitors did not lower the risk of any cardiorenal outcome when compared with placebo and were associated with higher risks of MACE, HHF, and renal outcome when compared with the other two drug classes. SGLT-2 inhibitors significantly reduced cardiovascular (RR = 0.88) and total (RR = 0.87) death, as compared with DPP-4 inhibitors, while GLP-1 RA reduced total death only (RR = 0.87). The comparison between GLP-1RA and SGLT-2 inhibitors showed no difference in their risks of MACE, nonfatal MI, nonfatal stroke, CV and total death; SGLT-2 inhibitors were superior to GLP-1RA in reducing the risk of HHF and the renal outcome (24% and 22% lower risk, respectively). Only GLP-1RA reduced the risk of nonfatal stroke (RR = 0.84), as compared with placebo. There was no head-to-head trial directly comparing these antidiabetic drug classes.

conclusionsSGLT-2 inhibitors and GLP-1RA are superior to DPP-4 inhibitors in reducing the risk of most cardiorenal outcomes; SGLT-2 inhibitors are superior to GLP-1RA in reducing the risk of HHF and renal events; GLP-1RA only reduced the risk of nonfatal stroke. Both SGLT-2 inhibitors and GLP-1RA should be the preferred treatment for type 2 diabetes and cardiorenal diseases.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsHeart FailureMyocardial InfarctionSodium-Glucose Transporter 2 InhibitorsStrokeGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsCardiovascular outcome trialsDPP-4 inhibitorsGLP-1 receptor agonistsNetwork meta-analysisSGLT-2 inhibitors

Identifiers

PMID35296336
PMCPMC8925229
OpenAlexW4220656413

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.