Effects of glucagon-like peptide 1 receptor agonists and sodium glucose cotransporter 2 inhibitors on major adverse cardiovascular events in type 2 diabetes by race, ethnicity, and region: A meta-analysis. Issue 49 (4th December 2020)

• Record Type: Journal Article
• Authors: Qiu, Mei; Ding, Liangliang; Wei, Xubin; Wei, Wei; Zhou, Hairong
• Other Names: Tu. Wen-Jun section editor.
• Is Part Of: Medicine. Volume 99:Issue 49(2020)
• Publication Date: 2020-12-04
• Subjects: cardiovascular events -- glucagon-like peptide 1 receptor agonists -- sodium-glucose cotransporter-2 inhibitors -- type 2 diabetes; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000023489
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Background: The effects of sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists on major adverse cardiovascular events (MACE) in type 2 diabetic subgroups defined by race, ethnicity, and region are unestablished. Methods: We searched PubMed and Embase for related randomized controlled trials. We conducted random-effects meta-analysis, stratified by drug class, on MACE in various subgroups defined by 3 factors of interest (ie, race, ethnicity, and region) to estimate pooled hazard ratio (HR) and 95% confidence interval. Random-effects meta-regression was conducted to evaluate the differences between 2 drug classes. Results: We included 11 randomized controlled trials for pooled analysis. Compared with placebo, SGLT2is and GLP-1 RAs significantly reduced the risk of MACE (HR ranged from 0.76 to 0.93) in most diabetic subgroups defined by 3 factors of interest. The 2 drug classes did not significantly reduced this risk in the Black race group (HR 0.92, 95% confidence interval 0.70–1.20). The effect of the 2 drug classes on MACE was not significantly different in all diabetic subgroups of interest ( P -value for subgroup differences ranged from .101 to .971). Conclusions: SGLT2is and glucagon-like peptide 1 receptor agonists can significantly reduce the risk of MACE in most type 2 diabetic subgroups defined by race, ethnicity, and region, whereas they fail to do it in Black individuals. Abstract : Supplemental Digital Content is available in the text