| Title | The cardiovascular effect of incretin-based therapies among type 2 diabetes: a systematic review and network meta-analysis |
| Authors | Wu, Shanshan Cipriani, Andrea Yang, Zhirong Yang, Jun Cai, Ting Xu, Yang Quan, Xiaochi Zhang, Yuan Chai, Sanbao Sun, Feng Zhan, Siyan |
| Affiliation | Capital Med Univ, Beijing Friendship Hosp, Natl Clin Res Ctr Digest Dis, Beijing, Peoples R China. Univ Oxford, Dept Psychiat, Oxford, England. Warneford Hosp, Oxford Hlth NHS Fdn Trust, Oxford, England. Univ Cambridge, Sch Clin Med, Dept Publ Hlth & Primary Care, Primary Care Unit, Cambridge, England. Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China. McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. Peking Univ, Int Hosp, Dept Endocrinol & Metab, Beijing, Peoples R China. Harvard Med Sch, Dept Populat Med, Boston, MA USA. Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China. Sun, F (reprint author), Harvard Med Sch, Dept Populat Med, Boston, MA USA. |
| Keywords | Incretin-based therapies type 2 diabetes network meta-analysis cardiovascular effect DIPEPTIDYL PEPTIDASE-4 INHIBITORS PEPTIDE-1 RECEPTOR AGONISTS RANDOMIZED CLINICAL-TRIALS LEVEL POOLED ANALYSIS GLYCEMIC CONTROL HEART-FAILURE DOUBLE-BLIND FOLLOW-UP OUTCOMES SAFETY |
| Issue Date | 2018 |
| Publisher | EXPERT OPINION ON DRUG SAFETY |
| Citation | EXPERT OPINION ON DRUG SAFETY. 2018, 17(3), 243-249. |
| Abstract | Objective: To evaluate the comparative cardiovascular safety of incretin-based therapies in patients with type 2 diabetes mellitus (T2DM). Methods: Medline, Embase, the Cochrane Library and www.clinicaltrials.gov were searched for randomized controlled trials (RCTs) with duration >= 12 weeks. Network meta-analysis was performed, followed by subgroup analysis and meta-regression. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the quality of evidence. The outcome of interest was a composite of cardiovascular death, myocardial infarction, stroke and heart failure. Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size. Results: 281 RCTs (76.9% double-blinded) with 180,000 patients were included, comparing incretin-based therapies with other six classes of anti-diabetic drugs or placebo. A statistically significant reduction in the risk of cardiovascular events was found in favour of GLP-1RAs when compared with placebo (OR 0.89, 95%CI: 0.80-0.99) and sulfonylurea (OR 0.76, 95%CI: 0.59-0.99), whereas DPP-4 inhibitors showed a neutral effect compared with placebo (OR 0.92, 95%CI: 0.83-1.01). Conclusions: Incretin-based therapies show similar cardiovascular risk in comparison with metformin, insulin, thiazolidinediones, alpha-glucosidase inhibitor and sodium-glucose co-transporter 2. GLP-1RA could decrease the risk compared with sulfonylurea or placebo, while DPP-4I appears to have neutral effect on cardiovascular risk. |
| URI | http://hdl.handle.net/20.500.11897/502488 |
| ISSN | 1474-0338 |
| DOI | 10.1080/14740338.2018.1424826 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 公共卫生学院 国际医院 |
