SGLT2 抑制剂对患者结果的影响:一个网络元分析
Jui-Yi Chen1,2, Heng-Chih Pan3,4,5,6, Chih-Chung Shiao7
1Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
Cardiovascular diabetology
|October 27, 2023
概括
这一网络元分析发现,恩帕格利弗洛辛在糖尿病患者中减少了全因死亡,而卡纳格利弗洛辛在非心力衰竭患者中降低了心血管事件. 较少选择性的SGLT2抑制剂改善了心力衰竭患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 在此之前,缺乏综合网络元分析,比较患有或没有糖尿病 (DM),心力衰竭 (HF) 和慢性病 (CKD) 的患者的单个-葡萄糖共运输体2 (SGLT2) 抑制剂.
- SGLT2 抑制剂代表心血管和脏保护的重要治疗类.
研究的目的:
- 进行网络元分析,比较DM,HF和CKD患者和没有DM的患者群体中的单个SGLT2抑制剂.
- 评估高选择性与低选择性SGLT2抑制剂的比较有效性.
主要方法:
- 搜索了PubMed,Embase,Cochrane和ClinicalTrials.gov的随机对照试验,直到2023年3月28日.
- 进行了随机效应网络元分析,以计算风险比率 (RR).
- 将SGLT2抑制剂分为高度选择性 (dapagliflozin, empagliflozin, ertugliflozin) 和不那么选择性 (canagliflozin, sotagliflozin) 的组,用于子组分析.
主要成果:
- 分析了14项试验,涉及75,334名患者.
- 与达帕格利弗洛辛使用者相比,使用Empagliflozin的DM患者群体中所有原因死亡的风险显著降低 (RR:0.81).
- 在非HF人群中,卡纳格利弗洛辛的使用者与达帕格利弗洛辛相比,心血管死亡或因HF (HHF) 入院的风险显著降低 (RR:0.75).
- 较少选择性的SGLT2抑制剂在HF患者中,与高度选择性的患者相比,显著降低了主要心血管不良事件 (MACE) 的风险 (RR:0.75).
结论:
- 与达帕格利弗洛辛相比,在糖尿病患者中使用empagliflozin与全因死亡率的降低有关.
- 与达帕格利弗洛辛相比,在没有HF的患者中使用卡纳格利弗洛辛可以减少心血管死亡或HHF风险.
- 与高度选择性药物相比,较少选择性的SGLT2抑制剂在HF患者中提供了优越的心血管综合结果.
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