Evidence map›Paper›PMID 36335326›Full record

ArticleCardiovascular diabetology2022

Network meta-analysis on the effects of finerenone versus SGLT2 inhibitors and GLP-1 receptor agonists on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus and chronic kidney disease.

Yaofu Zhang, Li Jiang, Junheng Wang, Tongxin Wang, Chieh Chien, Weijun Huang, Xiaozhe Fu, Yonghua Xiao, Qiang Fu, Shidong Wang and 1 more

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 52 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 13 pooled it
10.9field-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

52 citing papers in PubMed, 13 syntheses or guidelines pooled it, 78 citations in OpenAlex.

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  8. Cardiovascular Safety Profile of Semaglutide and Variations by Sex, Race, and Kidney Function: A Systematic Review and Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025 · on this map
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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

11 authors at 4 institutions in 2 countries.

Yaofu Zhang *Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Li Jiang *Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Junheng WangDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Tongxin WangNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Chieh ChienDepartment of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Weijun HuangKey Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing, China.
Xiaozhe FuDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Yonghua XiaoSection II of Endocrinology & Nephropathy Department of Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing, China.
Qiang FuSection II of Endocrinology & Nephropathy Department of Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing, China.
Shidong WangDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. 2486205408@qq.com.
Jinxi ZhaoDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. zhaojinximd@126.com.
Beijing University of Chinese Medicine · CNDongzhimen Hospital Affiliated to Beijing University of Chinese Medicine · CNChinese Academy of Medical Sciences & Peking Union Medical College · CNUniversity of Lucerne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the cardiovascular and renal benefits of finerenone, sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagonlike peptide-1 receptor agonists (GLP-1 RA) in patients with Type 2 Diabetes Mellitus (T2DM) and chronic kidney disease (CKD) with network meta-analysis.

methodsSystematic literature searches were conducted of PubMed, Cochrane Library, Web of Science, Medline and Embase covering January 1, 2000 to December 30, 2021. Randomized control trials (RCTs) comparing finerenone, SGLT-2i and GLP-1 RA in diabetics with CKD were selected. We performed a network meta-analysis to compare the two drugs and finerenone indirectly. Results were reported as risk ratio (RR) with corresponding 95% confidence interval (CI).

results18 RCTs involving 51,496 patients were included. Finerenone reduced the risk of major adverse cardiovascular events (MACE), renal outcome and hospitalization for heart failure (HHF) (RR [95% CI]; 0.88 [0.80-0.97], 0.86 [0.79-0.93], 0.79 [0.67,0.92], respectively). SGLT-2i were associated with reduced risks of MACE (RR [95% CI]; 0.84 [0.78-0.90]), renal outcome (RR [95% CI]; 0.67 [0.60-0.74], HHF (RR [95% CI]; 0.60 [0.53-0.68]), all-cause death (ACD) (RR [95% CI]; 0.89 [0.81-0.91]) and cardiovascular death (CVD) (RR [95% CI]; 0.86 [0.77-0.96]) compared to placebo. GLP-1 RA were associated with a lower risk of MACE (RR [95% CI]; 0.86 [0.78-0.94]). SGLT2i had significant effect in comparison to finerenone (finerenone vs SGLT2i: RR [95% CI]; 1.29 [1.13-1.47], 1.31 [1.07-1.61], respectively) and GLP-1 RA (GLP-1 RA vs SGLT2i: RR [95% CI]; 1.36 [1.16-1.59], 1.49 [1.18-1.89], respectively) in renal outcome and HHF.

conclusionsIn patients with T2DM and CKD, SGLT2i, GLP-1 RA and finerenone were comparable in MACE, ACD and CVD. SGLT2i significantly decreased the risk of renal events and HHF compared with finerenone and GLP-1 RA. Among GLP-1 RA, GLP-1 analogues showed significant effect in reducing cardiovascular events compared with exendin-4 analogues.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Renal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsNaphthyridinesfinerenoneGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsNaphthyridinesSodium-Glucose Transporter 2 InhibitorsCardiovascular outcomeChronic kidney diseaseFinerenoneGLP-1 receptor agonistNetwork meta-analysisRenal outcomeSGLT2 inhibitorsType 2 diabetes mellitus

Identifiers

PMID36335326
PMCPMC9637313
OpenAlexW4308246065

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LicenceCC BY
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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.