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Effects of sodium-g...
Effects of sodium-glucose cotransporter-2 inhibitors on cardiovascular disease, death and safety outcomes in type 2 diabetes - A systematic review
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- Rådholm, Karin, 1976- (author)
- Linköpings universitet,Avdelningen för samhällsmedicin,Medicinska fakulteten,Region Östergötland, Vårdcentralen Ödeshög,UNSW Sydney, Australia
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- Wu, Jason H. Y. (author)
- UNSW Sydney, Australia
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- Wong, Muh Geot (author)
- UNSW Sydney, Australia; Royal North Shore Hosp, Australia
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- Foote, Celine (author)
- UNSW Sydney, Australia; Concord Repatriat Gen Hosp, Australia
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- Fulcher, Gregory (author)
- Royal North Shore Hosp, Australia; Univ Sydney, Australia
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- Mahaffey, Kenneth W. (author)
- Stanford Univ, CA 94305 USA
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- Perkovic, Vlado (author)
- UNSW Sydney, Australia
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- Neal, Bruce (author)
- UNSW Sydney, Australia; Univ Sydney, Australia; Imperial Coll London, England
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(creator_code:org_t)
- ELSEVIER IRELAND LTD, 2018
- 2018
- English.
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In: Diabetes Research and Clinical Practice. - : ELSEVIER IRELAND LTD. - 0168-8227 .- 1872-8227. ; 140, s. 118-128
- Related links:
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http://spiral.imperi...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Aim: Sodium glucose co-transporter 2 (SGLT2) inhibitors appear to protect against increased risks of cardiovascular and kidney disease in patients with type 2 diabetes but also cause some harms. Whether effects are comparable across drug class or specific to individual compounds is unclear. This meta-analysis assessed the class and individual compound effects of SGLT2 inhibition versus control on cardiovascular events, death, kidney disease and safety outcomes in patients with type 2 diabetes. Methods: MEDLINE, EMBASE, the Cochrane Library and regulatory databases were systematically searched for data from randomized clinical trials that included reporting of cardiovascular events, deaths or safety outcomes. We used fixed effects models and inverse variance weighting to calculate relative risks with the 95% confidence intervals. Results: The analyses included data from 82 trials, four overviews and six regulatory reports and there were 1,968 major cardiovascular events identified for analysis. Patients randomly assigned to SGLT2 had lower risks of major cardiovascular events (RR 0.85, 95% CI 0.77-0.93), heart failure (RR 0.67, 95% CI 0.55-0.80), all-cause death (RR 0.79, 95% CI 0.70-0.88) and serious decline in kidney function (RR 0.59, 0.49-0.71). Significant adverse effects were observed for genital infections (RR 3.06, 95% CI 2.73-4.43), volume depletion events (RR 1.24, 95% CI 1.07-1.43) and amputation (RR 1.44 95% CI 1.13-1.83). There was a high likelihood of differences in the associations of the individual compounds with cardiovascular death, hypoglycaemia and amputation (all I-2 amp;gt; 80%) and a moderate likelihood of differences in the associations with non-fatal stroke, all-cause death, urinary tract infection and fracture (all I-2 amp;gt; 30%). Conclusion: There are strong overall associations of SGLT2 inhibition with protection against major cardiovascular events, heart failure, serious decline in kidney function and all-cause death. SGLT2 inhibitors were also associated with infections, volume depletion effects and amputation. Some associations appear to differ between compounds. (C) 2018 Elsevier B.V. All rights reserved.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Diabetes type 2; SGLT2 inhibitors; Cardiovascular disease; Kidney disease; Safety; Amputation; Fracture; Systematic review; Randomised controlled trials
Publication and Content Type
- ref (subject category)
- for (subject category)
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