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Journal of Endocrinological Investigation

Erschienen in:

01.03.2020 | Original Article

Sodium-glucose cotransporter 2 (SGLT-2) inhibitors and microvascular outcomes in patients with type 2 diabetes: systematic review and meta-analysis

verfasst von: E. G. Dorsey-Treviño, J. G. González-González, N. Alvarez-Villalobos, V. González-Nava, B. M. Contreras-Garza, A. Díaz González-Colmenero, G. Rodríguez-Tamez, F. J. Barrera-Flores, A. M. Farrell, V. M. Montori, R. Rodriguez-Gutierrez

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 3/2020

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Abstract

Purpose

The effect of the sodium-glucose 2 (SGLT-2) inhibitors on microvascular complications remains uncertain. We performed a systematic review to determine the efficacy of the SGLT-2 inhibitors on microvascular outcomes in patients with type 2 diabetes.

Methods

A comprehensive search was performed using Ovid, MEDLINE, EMBASE, Web of Science, and Scopus from inception to May 2019. Randomized trials comparing SGLT-2 inhibitors with placebo or other medication for type 2 diabetes for ≥ 4 weeks were included. Diabetes-related microvascular complications such as nephropathy, retinopathy, neuropathy, and peripheral vascular disease were evaluated. A random-effect model using mean differences for continuous outcomes and risk ratio for dichotomous outcomes was used to synthesize data. PROSPERO (CRD 42017076460).

Results

A total of 40 RCTs with overall moderate quality of evidence were included. SGLT-2 inhibitors reduced the risk of renal-replacement therapy (0.65; 95% CI 0.54–0.79), renal death (0.57; 95% CI 0.49–0.65), and progression of albuminuria (0.69; 95% CI 0.66–0.73). Conversely, they appeared ineffective in maintaining eGFR (0.33; 95% CI − 0.74 to 1.41) or reducing serum creatinine (− 0.07; 95% CI − 0.26 to 0.11), whereas urine albumin–creatinine ratio (− 23.4; 95% CI − 44.6 to − 2.2) was reduced. Risk of amputation was non-significant (1.30; 95% CI 0.93–1.83). No available data were found regarding neuropathy and retinopathy to perform a quantitative analysis.

Conclusion

SGLT-2 inhibitors may reduce the risk of renal patient-important outcomes but fail to improve surrogate outcomes. Apparently, no increased risk of amputations was observed with these medications. No data were available regarding other microvascular complications.

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Titel: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors and microvascular outcomes in patients with type 2 diabetes: systematic review and meta-analysis
verfasst von: E. G. Dorsey-Treviño
J. G. González-González
N. Alvarez-Villalobos
V. González-Nava
B. M. Contreras-Garza
A. Díaz González-Colmenero
G. Rodríguez-Tamez
F. J. Barrera-Flores
A. M. Farrell
V. M. Montori
R. Rodriguez-Gutierrez
Publikationsdatum: 01.03.2020
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 3/2020
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-019-01103-9

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