Clinical efficacy and safety of sodium-glucose cotransporter protein-2 (SGLT-2) inhibitor, glucagon-like peptide-1 (GLP-1) receptor agonist, and Finerenone in type 2 diabetes mellitus with non-dialysis chronic kidney disease: a network meta-analysis of randomized clinical trials
Abstract
OBJECTIVE: To investigate the safety and clinical efficacy of sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists and Finerenone in treating patients with type 2 diabetes mellitus (T2DM) combined with non-dialysis chronic kidney disease (CKD).
METHODS: Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, CQVIP database, and WanFang from their inception up to November 2023 were searched to compare the efficacy and safety of SGLT-2 inhibitors, GLP-1 RA receptor agonists and Finerenone in the treatment of T2DM patients with non-dialysis CKD. To assess the methodological quality and risk of bias in the included studies, we utilized the Cochrane Risk of Bias Assessment tool (RoB 2.0). The confidence of evidence was examined using Confidence in Network Meta-Analysis (CINeMA). Traditional meta-analysis of variables was conducted using Stata 17.0 software with a random-effects model. We assessed publication bias using funnel plots and explored potential sources of heterogeneity through subgroup analysis.
RESULTS: A total of 39 studies (99,599 patients) were included. Compared to Placebo (PBO), SGLT-2 inhibitors demonstrated superior efficacy in reducing glycosylated hemoglobin (HbA1c) (MD = -0.33; 95%CI: from -0.52 to -0.15), systolic blood pressure (SBP) (MD from -5.52 to -1.50; 95%CI from -8.80 to -0.23), body weight (MD from -3.81 to -1.29; 95%CI from -6.34 to -0.84) and diastolic blood pressure (DBP) (MD = -1.86;…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 99,599 participants or records.
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