Evidence map›Paper›PMID 35670826›Full record

SynthesisEuropean journal of clinical pharmacology2022

Exploring heterogeneities of cardiovascular efficacy and effectiveness of SGLT2 inhibitors in patients with type 2 diabetes: an umbrella review of evidence from randomized clinical trials versus real-world observational studies.

Bojung Seo, Jialin Su, Yiqing Song

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Reply to Lixin Du et al.European journal of clinical pharmacology · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Bojung SeoDepartment of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, IN, Indianapolis, 46202, USA.ORCID http://orcid.org/0000-0001-5619-2476
Jialin SuCardiology Professional Services of Berkshire Medical Center, 777 North St, MB, Pittsfield, 01201, USA.
Yiqing SongDepartment of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, IN, Indianapolis, 46202, USA. yiqsong@iu.edu.ORCID http://orcid.org/0000-0002-2097-7332

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to explore possible contributors to discrepancies between randomized controlled trials (RCTs) and real-world observational studies (OS) in cardiovascular benefits of sodium-glucose cotransporter 2 (SGLT2) inhibitors in type 2 diabetes (T2D) patients.

methodsWe searched PubMed and EMBASE to identify meta-analyses of RCTs and OS on cardiovascular effects of SGLT2 inhibitors in T2D patients. Cardiovascular outcomes included major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, cardiovascular mortality (CVM), all-cause mortality (ACM), hospitalization for heart failure (HHF), and atrial fibrillation (AF). We examined the summary relative risk (RR) and 95% confidence interval (CI) for each endpoint from meta-analyses of RCTs.

resultsWe identified and included 15 eligible meta-analyses, 13 for RCTs and 2 for OS, with moderately strong evidence. The results revealed a significant discrepancy between RCTs and OS for MI (RR, 95% CI 1.05, 0.82-1.38; I = 91.5% versus odds ratio (OR), 95% CI 0.77, 0.73-0.81; I = 15.0%), stroke (RR, 95% CI 0.99, 0.76-1.29; I = 93.4% versus OR, 95% CI 0.75, 0.72-0.78; I = 23.0%), and AF (RR, 95% CI 0.72, 0.62-0.85; I = 0.0% versus OR, 95% CI 0.92, 0.83-1.02; I = 0.0%).

conclusionOS presented significant benefits of SGLT2 inhibitors both on primary and secondary preventions of MACE, MI, stroke, ACM, CVM, and HHF; RCTs did not. Given the spectrum of T2D patient characteristics and the strength of overall evidence, our review underscored the importance of constant integration of all available information and critical interpretation of all inconsistencies to optimize evidence-based diabetes care.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Heart FailureMyocardial InfarctionSodium-Glucose Transporter 2 InhibitorsStrokeHumansRandomized Controlled Trials as TopicSodium-Glucose Transporter 2 InhibitorsRandomized clinical trialsReal-world evidenceSodium-glucose cotransporter 2 inhibitorsType 2 diabetes

Identifiers

PMID35670826

What OpenQuestion holds

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Registered trials

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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.