Academic Journal
Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria: A Meta-Analysis
| Τίτλος: | Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria: A Meta-Analysis |
|---|---|
| Συγγραφείς: | Staplin, N, Roddick, AJ, Neuen, BL, Anker, SD, Bhatt, DL, Butler, J, Cherney, DZ, Docherty, KF, Fletcher, RA, Inzucchi, SE, Jardine, M, Mahaffey, KW, Mcguire, DK, Mcmurray, JJV, Neal, B, Packer, M, Patel, SM, Perkovic, V, Sabatine, MS, Solomon, S, Vaduganathan, M, Wanner, C, Wheeler, DC, Zannad, F, Haynes, R, Heerspink, HJL, Herrington, WG |
| Πηγή: | Journal of the American Medical Association (2025) (In press). |
| Στοιχεία εκδότη: | American Medical Association (AMA) |
| Έτος έκδοσης: | 2025 |
| Συλλογή: | University College London: UCL Discovery |
| Θεματικοί όροι: | Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine |
| Περιγραφή: | Importance: There is uncertainty about the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors in participants with chronic kidney disease, with guidelines offering different strengths of recommendation based on diabetes status and urine albumin to creatinine ratio (UACR). Objective: To assess the relative and absolute effects of SGLT2 inhibitor use across efficacy and serious safety outcomes in participants stratified by diabetes status and UACR (≥200 mg/g or <200 mg/g). Data Sources and Study Selection: Included 8 randomized clinical trials that studied an SGLT2 inhibitor with a label indication for use in kidney disease and recorded longitudinal kidney outcomes and baseline data on albuminuria. Data Extraction and Synthesis: Data were combined using inverse variance-weighted meta-analysis; group-specific absolute effects were estimated by applying relevant relative risks to the event rates of the placebo groups. Main Outcomes and Measures: Assessed the effects of SGLT2 inhibitor use on clinical efficacy and safety outcomes. Heterogeneity by baseline level of UACR was assessed separately by diabetes status. Results: A total of 58816 participants (mean age, 64 [SD, 10] years; 35% were female; 48946 with diabetes and 9870 without diabetes) were included from trials comparing an SGLT2 inhibitor vs placebo. Allocation to an SGLT2 inhibitor produced a lower rate of kidney disease progression (33 vs 48 for placebo per 1000 patient-years; hazard ratio [HR], 0.65 [95% CI, 0.60-0.70] in those with diabetes and 32 vs 46 per 1000; HR, 0.74 [95% CI, 0.63-0.85] in those without diabetes), a lower rate of acute kidney injury (14 vs 18 per 1000 [HR, 0.77; 95% CI, 0.69-0.87] with diabetes and 13 vs 18 per 1000 [HR, 0.72; 95% CI, 0.56-0.92] without diabetes), a lower rate of any hospitalization (202 vs 231 per 1000 [HR, 0.90; 95% CI, 0.87-0.92] with diabetes and 203 vs 237 per 1000 [HR, 0.89; 95% CI, 0.83-0.95] without diabetes), and a lower rate of any death (42 vs 47 per 1000 [HR, 0.86; 95% CI, 0.80-0.91] with ... |
| Τύπος εγγράφου: | article in journal/newspaper |
| Περιγραφή αρχείου: | application/pdf |
| Γλώσσα: | English |
| Relation: | https://discovery.ucl.ac.uk/id/eprint/10219805/ |
| Διαθεσιμότητα: | https://discovery.ucl.ac.uk/id/eprint/10219805/1/Wheeler_SMART-C%20meta%20analysis%20eGFR%20albuminuria_merged_1759512634.pdf https://discovery.ucl.ac.uk/id/eprint/10219805/ |
| Rights: | open |
| Αριθμός Καταχώρησης: | edsbas.2D04D5AD |
| Βάση Δεδομένων: | BASE |
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