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Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data

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Titel: Absolute treatment effects of novel antidiabetic drugs on a composite renal outcome: meta-analysis of digitalized individual patient data
Autoren: Brockmeyer, M, Parco, C, Vargas, KG, Westenfeld, R, Jung, C, Kelm, M, Roden, M, Akbulut, C, Schlesinger, S, Wolff, G, Kuss, O
Quelle: J Nephrol
Verlagsinformationen: Springer Science and Business Media LLC, 2024.
Publikationsjahr: 2024
Schlagwörter: 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Diabetes Mellitus, Type 2, Glucagon-Like Peptide-1 Receptor Agonists, Kidney/drug effects [MeSH], Sodium-Glucose Transporter 2 Inhibitors/therapeutic use [MeSH], Glucagon-Like Peptide-1 Receptor/agonists [MeSH], Humans [MeSH], Treatment Outcome [MeSH], Absolute treatment effect, Diabetes Mellitus, Type 2/drug therapy [MeSH], Original Article, Kidney/physiopathology [MeSH], SGLT2 inhibitor, Composite renal outcome, GLP-1 receptor agonist, Hypoglycemic Agents/therapeutic use [MeSH], Glomerular Filtration Rate/drug effects [MeSH], Humans, Hypoglycemic Agents, Kidney, Sodium-Glucose Transporter 2 Inhibitors, Glomerular Filtration Rate, 3. Good health
Beschreibung: Background Absolute treatment benefits—expressed as numbers needed to treat—of the glucose lowering and cardiovascular drugs, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors on renal outcomes remain uncertain. With the present meta-analysis of digitalized individual patient data, we aimed to display and compare numbers needed to treat of both drugs on a composite renal outcome. Methods From Kaplan–Meier plots of major cardiovascular outcome trials of GLP-1 receptor agonists and SGLT2 inhibitors vs. placebo, we digitalized individual patient time-to-event information on composite renal outcomes with WebPlotDigitizer 4.2; numbers needed to treat from individual cardiovascular outcome trials were estimated using parametric Weibull regression models and compared to original data. Random-effects meta-analysis generated meta-numbers needed to treat with 95% confidence intervals (CI). Results Twelve cardiovascular outcome trials (three for GLP-1 receptor agonists, nine for SGLT2 inhibitors) comprising 90,865 participants were included. Eight trials were conducted in primary type 2 diabetes populations, two in a primary heart failure and two in a primary chronic kidney disease population. Mean estimated glomerular filtration rate at baseline ranged between 37.3 and 85.3 ml/min/1.73 m2. Meta-analyses estimated meta-numbers needed to treat of 85 (95% CI 60; 145) for GLP-1 receptor agonists and 104 (95% CI 81; 147) for SGLT2 inhibitors for the composite renal outcome at the overall median follow-up time of 36 months. Conclusion The present meta-analysis of digitalized individual patient data revealed moderate and similar absolute treatment benefits of GLP-1 receptor agonists and SGLT2 inhibitors compared to placebo for a composite renal outcome. Graphical Abstract
Publikationsart: Article
Other literature type
Sprache: English
ISSN: 1724-6059
DOI: 10.1007/s40620-023-01858-8
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/38236473
https://ora.ox.ac.uk/objects/uuid:066446b5-3fe9-40b5-b2fe-6683acbc977b
https://doi.org/10.1007/s40620-023-01858-8
https://repository.publisso.de/resource/frl:6522178
Rights: CC BY
Dokumentencode: edsair.doi.dedup.....d77f847301194e002f13725ee40bcee6
Datenbank: OpenAIRE
Beschreibung
Abstract:Background Absolute treatment benefits—expressed as numbers needed to treat—of the glucose lowering and cardiovascular drugs, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors on renal outcomes remain uncertain. With the present meta-analysis of digitalized individual patient data, we aimed to display and compare numbers needed to treat of both drugs on a composite renal outcome. Methods From Kaplan–Meier plots of major cardiovascular outcome trials of GLP-1 receptor agonists and SGLT2 inhibitors vs. placebo, we digitalized individual patient time-to-event information on composite renal outcomes with WebPlotDigitizer 4.2; numbers needed to treat from individual cardiovascular outcome trials were estimated using parametric Weibull regression models and compared to original data. Random-effects meta-analysis generated meta-numbers needed to treat with 95% confidence intervals (CI). Results Twelve cardiovascular outcome trials (three for GLP-1 receptor agonists, nine for SGLT2 inhibitors) comprising 90,865 participants were included. Eight trials were conducted in primary type 2 diabetes populations, two in a primary heart failure and two in a primary chronic kidney disease population. Mean estimated glomerular filtration rate at baseline ranged between 37.3 and 85.3 ml/min/1.73 m2. Meta-analyses estimated meta-numbers needed to treat of 85 (95% CI 60; 145) for GLP-1 receptor agonists and 104 (95% CI 81; 147) for SGLT2 inhibitors for the composite renal outcome at the overall median follow-up time of 36 months. Conclusion The present meta-analysis of digitalized individual patient data revealed moderate and similar absolute treatment benefits of GLP-1 receptor agonists and SGLT2 inhibitors compared to placebo for a composite renal outcome. Graphical Abstract
ISSN:17246059
DOI:10.1007/s40620-023-01858-8