Effects of anti-diabetes medications on cardiovascular and kidney outcomes in Asian patients with type 2 diabetes: a rapid evidence assessment and narrative synthesis. Issue 6 (3rd June 2021)

• Record Type: Journal Article
• Authors: Kadowaki, Takashi; Yamamoto, Fumiko; Taneda, Yusuke; Naito, Yusuke; Clark, Douglas; Lund, Søren S.; Okamura, Tomoo; Kaku, Kohei
• Is Part Of: Expert opinion on drug safety. Volume 20:Issue 6(2021)
• Page Start: 707
• Page End: 720
• Publication Date: 2021-06-03
• Subjects: Asians -- diabetes mellitus type 2 -- dipeptidyl-peptidase IV inhibitors -- glucagon-like peptide-1 receptor agonists -- patient outcomes -- sodium-glucose transporter 2 inhibitors; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2021.1898585
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Background: The cardiovascular and kidney safety of glucose-lowering drugs is a key concern in type 2 diabetes (T2D). We evaluated cardiorenal outcomes with glucose-lowering drugs in Asian patients, who comprise over half of T2D cases globally. Research design and methods: A rapid evidence assessment was conducted for phase III or IV, double-blind, randomized clinical trials of glucose-lowering drugs reporting cardiovascular or kidney outcomes for Asian T2D patients (Embase, Medline, Cochrane Library databases: 1 January 2008–14 June 2020). Results: Fifty-four publications reported exploratory data for Asians from 18 trials of dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose co-transporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and insulin analogs. SGLT2 inhibitors and several GLP-1 receptor agonists were associated with reduced cardiovascular risk in Asian T2D patients, while DPP-4 inhibitors exhibited cardiovascular safety. SGLT2 inhibitors also appeared to reduce renal risk; however, kidney outcomes were lacking for DPP-4 inhibitors other than linagliptin and GLP-1 receptor agonists in Asian patients. Insulin data were inconclusive as the only trial conducted used different types of insulin as both treatment and comparator. Conclusions: Cardiorenal outcomes with glucose-lowering drugs in Asian T2D patients were similar to outcomes in the overall multinational cohorts of these trials. DPP-4 inhibitors appear to demonstrate cardiovascular safety in Asians, while SGLT2 inhibitors and some GLP-1 receptor agonists may reduce cardiorenal and cardiovascular risk, respectively.